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Current Vascular Pharmacology

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ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

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Research Article

COVID-19-associated Coagulopathy and Thromboembolism: Determination of Their Patterns and Risk Factors as Predictors of Mortality Among Severe COVID-19 Patients

Author(s): Iftikhar Haider Naqvi*, Muhammad Tanveer Alam, Muhammad Rehan, Khalid Mahmood, Muhammad Aurangzeb and Abu Talib

Volume 20, Issue 1, 2022

Published on: 14 October, 2021

Page: [77 - 86] Pages: 10

DOI: 10.2174/1570161119666211014162409

Price: $65

Abstract

Background: Coronavirus Disease 2019 (COVID-19) is associated with Coagulopathy (CAC) and Venous Thromboembolism (VTE). These are well-reported complications of COVID-19 infection. Earlier publications have shown that CAC and thromboembolism are predictors of mortality among COVID-19 patients with severe disease.

Materials and Methods: A prospective study was conducted in the Intensive Care Unit (ICU) where all confirmed COVID-19 patients were enrolled and followed until death or ICU discharge. CAC, VTE, along with all comorbidities, were recorded. Predictors of mortality were determined by univariate and multivariate regression.

Results: Among 261 patients with COVID-19, 48.3% survived and 51.7% died. CAC was present in 53.2% and 76.3% of the survivors and non-survivors, respectively (p<0.001); 89 patients (31.4%) had VTE (p=0.36) and 11 patients (4.2%) had arterial thrombosis (p=0.76) among survivors and nonsurvivors. Age between 71-80 years (p=0.009), male gender (p=0.045), CAC (p<0.001), comorbidities like chronic kidney disease (CKD, p=0.013), chronic obstructive pulmonary disease (COPD, p=0.001) and asthma (p=0.046), were significant predictors of mortality.

Conclusion: A severe complication of COVID-19 is CAC, such as sepsis-induced coagulopathy, overt disseminated-coagulopathy and VTE. Old age, various comorbidities (e.g., COPD, CKD, or asthma), CAC, VTE (pulmonary embolism) and coagulation parameters with critical severity score (D-dimers, platelets, prothrombin time) and the SOFA (Sequential Organ Failure Assessment) score were significant predictors of mortality among COVID-19 patients.

Keywords: Venous thromboembolism, COVID-19-associated coagulopathy, sepsis-induced coagulopathy, overt disseminated intravascular coagulation, mortality, COPD.

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