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Hemostasis Disorder in COVID-19 Patients: Disseminated Intravascular Clotting (DIC)?

E. Klychnikova1, K. Popugaev1, E. Tazina1, S. Petrikov1, S. Badygov1, A. Bulanov1

1N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department, Moscow, Russian Federation

Abstract Number: PB0266

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: Hemostasis disorders in COVID-19 have specific clinical and laboratory features that differ from the “classic” form of DIC.

Aims:  To investigate the change in hemostasis indices in patients with severe course of COVID-19.

Methods: A prospective study of 122 patients (men 53%, women 47%) with a severe course of COVID-19 was carried out. The age was 59 ±12 years. The patients’ condition, assessed by the NEWS and SOFA severity score, was 4.5 ± 1.4 and 6.1 ± 1.3 points. The control group was consisted of 20 apparently healthy donors. The research was performed on the 1st and 7th days from the moment of admission to the hospital.

Results: There was a significant increase of D-dimer’s level in patients  on the first day (1.17 (0.45-4.09) mg/l, p˂0.001) and on the 7th day (1.28 (0.46-3.23) mg/l, p˂0.001). FG level was also significantly high in patients  on the 1st day of the study (4.93 (3.49-6.11) g/l, p˂0.001) and on day 7 (4.23 (3.15-5.68) g/l, p˂0.001). PT was significantly lower in patients with COVID-19 than in the control group on the 1st day (78.7 (68.0-91.0) %, p=0.0003) and remained within normal values on the 7th day. Platelet count was significantly lower in patients than in the control group on the 1st day (190 (127-266) 109/l, p=0.006) and remained within normal values on the 7 th day. We calculated the index according to the ISTH’s scoring scale and found that most patients with COVID-19 didn’t  score points to diagnose DIC-syndrome (Fig. 1).
Figure 1. Scoring scale to confirm DIC in patients with COVID-19 who were being treated in N.V. Sklifosovsky Research Institute for Emergency Medicine.

Conclusions: According to our data, prolongation of prothrombin time, thrombocytopenia and hypofibrinogenemia, decrease of antithrombin III in patients with COVID-19 on the 1st day and 7th were rare. Most patients showed a significant increase of D-dimer, the rest of the hemostasis indices didn’t correspond to the DIC-syndrome.

To cite this abstract in AMA style:

Klychnikova E, Popugaev K, Tazina E, Petrikov S, Badygov S, Bulanov A. Hemostasis Disorder in COVID-19 Patients: Disseminated Intravascular Clotting (DIC)? [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/hemostasis-disorder-in-covid-19-patients-disseminated-intravascular-clotting-dic/. Accessed September 29, 2023.

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