Abstract Number: PB0255
Meeting: ISTH 2021 Congress
Background: Covid-19 appeared quaint with evolving hyper-inflammation phase, vasculoendothelial dysfunction, and a distinct coagulopathy.
Aims: We present our experience regarding coagulopathy predictive factors in hospitalized Covid-19 patients just after pandemic declaration.
Methods: The data were obtained retrospectively by screening the institution’s electronic data system between March and May 2020. The treatment protocol based on Health Ministry guidelines, includes hydroxychloroquine, azithromycin, favipiravir, low-molecular-weight heparin, dipyridamole, and anti-cytokine agents on the hyper-inflammation phase. We stratified 3 groups, patients with proven coagulopathy, highly suspected coagulopathy, and patients without coagulopathy. Highly suspected coagulopathy encompasses clinical deterioration with sudden and inconsistent D-dimer elevation.
Results: A total of 511 patients were screened. Forty-nine of them were excluded due to accompanying conditions resulting in high D-dimer levels. The median age of the remaining patients was 56 years with a male/female ratio of 284/178. Proven coagulopathy as documented thrombosis developed in 3.2% with a male predominance (60%). Highly suspected coagulopathy was decided in 10.1% of patients.
Among predictive factors for coagulopathy, the risk factors at admission were being over 65-year-old, having coronary artery disease, dyspnea, severe lymphopenia (<500/µl), monocytopenia (<300/µl), and elevated LDH. For highly suspected coagulopathy, in addition to these having more than 3 comorbidities, high initial ferritin (>1000 ng/ml) and d-dimer levels as greater than 3600 U/ml were also predictive.
The clinical pictures in the proven coagulopathy group included 5 myocardial infarctions, 4 disseminated intravascular coagulation (DIC), 2 deep vein thrombosis, 1 catheter-related venous thrombosis, 1 catheter-related venous thrombosis, and pulmonary embolism, 1 lower extremity arterial thrombosis, 1 stroke. All DIC cases had gram-negative bacterial sepsis.
Conclusions: Our data suggest coagulopathy is not directly correlated with inflammation severity but patients in hyperinflamation phase should be pursued for possible proven coagulopathy.
To cite this abstract in AMA style:Tor YB, Kalayoglu Besisik S, Ozbalak M, Kose M, Medetalibeyoglu A, Senkal N, Cagatay A, Simsek Yavuz S, Gul A, Erelel M, Esen F, Tukek T. Cross-talk between the Inflammatory Response and Coagulopathy: Single-center Report [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/cross-talk-between-the-inflammatory-response-and-coagulopathy-single-center-report/. Accessed December 10, 2023.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/cross-talk-between-the-inflammatory-response-and-coagulopathy-single-center-report/