Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.402
Filtrar
1.
BMC Pregnancy Childbirth ; 21(1): 108, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546624

RESUMO

BACKGROUND: As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. METHODS: Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed. RESULTS: One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two. CONCLUSIONS: Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.


Assuntos
/epidemiologia , Coagulação Intravascular Disseminada/epidemiologia , Complicações Cardiovasculares na Gravidez/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Tromboembolia/epidemiologia , Trombose Venosa/epidemiologia , /virologia , Comorbidade , Coagulação Intravascular Disseminada/virologia , Feminino , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/virologia , Complicações Hematológicas na Gravidez/virologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Tromboembolia/virologia , Trombose Venosa/virologia
2.
Mo Med ; 118(1): 68-73, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551489

RESUMO

Magnesium and vitamin D each have the possibility of affecting the immune system and consequently the cytokine storm and coagulation cascade in COVID-19 infections. Vitamin D is important for reducing the risk of upper respiratory tract infections and plays a role in pulmonary epithelial health. While the importance of vitamin D for a healthy immune system has been known for decades, the benefits of magnesium has only recently been elucidated. Indeed, magnesium is important for activating vitamin D and has a protective role against oxidative stress. Magnesium deficiency increases endothelial cell susceptibility to oxidative stress, promotes endothelial dysfunction, reduces fibrinolysis and increases coagulation. Furthermore, magnesium deficient animals and humans have depressed immune responses, which, when supplemented with magnesium, a partial or near full reversal of the immunodeficiency occurs. Moreover, intracellular free magnesium levels in natural killer cells and CD8 killer T cells regulates their cytotoxicity. Considering that magnesium and vitamin D are important for immune function and cellular resilience, a deficiency in either may contribute to cytokine storm in the novel coronavirus 2019 (COVID-19) infection.


Assuntos
/complicações , Síndrome da Liberação de Citocina/etiologia , Coagulação Intravascular Disseminada/etiologia , Doenças do Sistema Imunitário/etiologia , Deficiência de Magnésio/complicações , Deficiência de Vitamina D/complicações , Animais , Linfócitos T CD8-Positivos/efeitos dos fármacos , /tratamento farmacológico , Humanos , Células Matadoras Naturais/efeitos dos fármacos , Magnésio/administração & dosagem , Magnésio/farmacologia , Magnésio/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , /genética , Vitamina D/administração & dosagem , Vitamina D/farmacologia , Vitamina D/uso terapêutico , Vitaminas/administração & dosagem , Vitaminas/farmacologia , Vitaminas/uso terapêutico
3.
Int J Hematol ; 113(1): 24-33, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33386597

RESUMO

Disseminated intravascular coagulation (DIC) is a common and life-threatening complication in sepsis. Sepsis-associated DIC is recognized as the systemic activation in coagulation with suppressed fibrinolysis that leads to organ dysfunction in combination with systemic intravascular inflammation. In this process, thrombin contributes a key role in connecting both coagulation and inflammation. Endothelial injury, a result of sepsis, causes DIC due to the effect of multiple activated factors that include neutrophils, platelets, and damage-associated molecular patterns. Recent advances in the understanding of pathophysiology have made it possible to diagnose sepsis-associated DIC at earlier timing with better accuracy. However, progress in the treatment is still limited, and new therapeutics for sepsis-associated DIC are needed.


Assuntos
Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/etiologia , Sepse/complicações , Plaquetas , Coagulação Intravascular Disseminada/diagnóstico , Diagnóstico Precoce , Células Endoteliais , Fibrinólise , Humanos , Inflamação , Neutrófilos , Prognóstico , Trombina/fisiologia
4.
Clin Appl Thromb Hemost ; 27: 1076029620987629, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33443456

RESUMO

Coagulation activation has been reported in several cohorts of patients Coronavirus Disease 2019 (COVID-19). However, the true burden of systemic coagulopathy in COVID-19 remains unknown. In this systematic review and meta-analysis, we performed a literature search using PubMed, EMBASE, and Cochrane Database to identify studies that reported the prevalence of systemic coagulopathy using established criteria in patients with COVID-19. The primary outcome was the prevalence of systemic coagulopathy (disseminated intravascular coagulation [DIC] and/or sepsis-induced coagulopathy [SIC]). Pooled prevalences and 95% confidence intervals [CIs] were calculated using random-effects model. A total of 5 studies including 1210 patients with confirmed COVID-19 were included. The pooled prevalence of systemic coagulopathy was 7.1% (95%CI: 3.2%,15.3%, I2 = 93%). The pooled prevalence of DIC (N = 721) and SIC (N = 639) were 4.3% (95%CI 1.7%, 10.4%, I2 = 84%) and 16.2% (95%CI: 9.3%, 26.8%, I2 = 74%), respectively. Only 2 studies reported the prevalence of elevated D-dimer levels with the pooled prevalence of 84.6% (95%CI: 52.0%,96.5%, I2 = 94%). Average D-dimer and fibrinogen levels were remarkably increased, while platelet counts, PT, and aPTT ratios were minimally affected in COVID-19. The estimated prevalence of systemic coagulopathy in patients with COVID-19 was low despite D-dimer elevation in most patients. Relatively low systemic coagulopathy in COVID-19 may contribute to the high incidence of thrombosis rather than bleeding in patients with COVID-19.


Assuntos
Coagulação Intravascular Disseminada , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Sepse , Trombose , /sangue , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/epidemiologia , Feminino , Humanos , Masculino , Contagem de Plaquetas , Prevalência , Sepse/sangue , Sepse/epidemiologia , Trombose/sangue , Trombose/epidemiologia
5.
Clin Lab ; 67(1)2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33491434

RESUMO

BACKGROUND: In 2020, the SARS-CoV-2 virus spread worldwide and infected more that 10 million people, causing more than 500,000 deaths worldwide. The infection has systemic effects on the respiratory and cardiovascular systems; thus, patients can present a variety of symptoms from asymptomatic to rapid deaths. In this paper, we present the first case of post-mortem SARS-CoV-2 molecular testing in Western part of Romania in a deceased with disseminated intravascular coagulation (DIC) and elevated D-dimer levels. METHODS: During the autopsy which took place at the Institute of Forensic Medicine from Timisoara, Romania, blood sample was collected in a vacutainer with EDTA and sent to the Laboratory of Forensic Genetics from Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. Viral RNA extraction was performed automated on the Maxwell 48 RSC Extraction System (Promega, USA) using the Maxwell RSC Viral Total Nucleic Acid Purification kit (Promega, USA). After RNA extraction, the samples were amplified on a 7500 real-time PCR (Applied Biosystems, USA) using the genesig® Real-Time PCR Assay (Primer Design, UK). RESULTS: The molecular testing showed a cycle threshold value of 23.4 (1.2 x 106 copies/mL), indicating increased viral loads, which correlated with the laboratory analysis results, especially with D-dimer levels. CONCLUSIONS: In cases of coagulopathy of SARS-CoV-2, patients in hospitals should be monitored closely for thrombosis development. Thus D-dimer can be used as prognostic marker in monitoring the evolution of SARS-CoV-2 infected patients.


Assuntos
/diagnóstico , Coagulação Intravascular Disseminada/diagnóstico , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Autopsia , Biomarcadores/sangue , /complicações , Causas de Morte , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/virologia , Evolução Fatal , Humanos , Insuficiência de Múltiplos Órgãos/virologia , Valor Preditivo dos Testes , Romênia , Regulação para Cima
6.
Medicina (Kaunas) ; 57(2)2021 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-33498929

RESUMO

COVID-19 has been associated with a hypercoagulable state and thrombotic events. Venous thromboembolism has been the most commonly reported type of thrombosis but also arterial thrombosis and disseminated intravascular coagulation in inpatients have been described frequently in several clinical experiences. Patients with COVID-19, because of its tendency to induce leucopenia and overlapping of bacterial infection, may experience sudden disseminated intravascular coagulation (DIC), as in the case that we report here. However, early diagnosis and treatment may be associated with positive resolution of these severe complications.


Assuntos
/complicações , Coagulação Intravascular Disseminada/virologia , Neutropenia/virologia , Sepse/virologia , /virologia , Humanos , Masculino , Pessoa de Meia-Idade
7.
Cardiol Rev ; 29(1): 43-47, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32947478

RESUMO

The novel coronavirus (severe acute respiratory syndrome CoV-2 [SARS-CoV-2]), also known as COVID-19, is a single-stranded enveloped RNA virus that created a Public Health Emergency of International Concern in January 2020, with a global case burden of over 15 million in just 7 months. Infected patients develop a wide range of clinical manifestations-typically presenting with fever, cough, myalgia, and fatigue. Severely ill patients may fall victim to acute respiratory distress syndrome, acute heart injuries, neurological manifestations, or complications due to secondary infections. These critically ill patients are also found to have disrupted coagulation function, predisposing them to consumptive coagulopathies, and both venous and thromboembolic complications. Common laboratory findings include thrombocytopenia, elevated D-dimer, fibrin degradation products, and fibrinogen, all of which have been associated with greater disease severity. Many cases of pulmonary embolism have been noted, along with deep vein thrombosis, ischemic stroke, myocardial infarction, and systemic arterial embolism. The pathogenesis of coronavirus has not been completely elucidated, but the virus is known to cause excessive inflammation, endothelial injury, hypoxia, and disseminated intravascular coagulation, all of which contribute to thrombosis formation. These patients are also faced with prolonged immobilization while staying in the hospital or intensive care unit. It is important to have a high degree of suspicion for thrombotic complications as patients may rapidly deteriorate in severe cases. Evidence suggests that prophylaxis with anticoagulation may lead to a lower risk of mortality, although it does not eliminate the possibility. The risks and benefits of anticoagulation treatment should be considered in each case. Patients should be regularly evaluated for bleeding risks and thrombotic complications.


Assuntos
Transtornos da Coagulação Sanguínea/sangue , Embolia/sangue , Trombose/sangue , Anticoagulantes/uso terapêutico , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Transtornos da Coagulação Sanguínea/etiologia , Transtornos da Coagulação Sanguínea/metabolismo , /tratamento farmacológico , Síndrome da Liberação de Citocina/sangue , Síndrome da Liberação de Citocina/complicações , Síndrome da Liberação de Citocina/metabolismo , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/metabolismo , Coagulação Intravascular Disseminada/prevenção & controle , Embolia/etiologia , Embolia/metabolismo , Embolia/prevenção & controle , Endotélio Vascular/metabolismo , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Fibrinogênio/metabolismo , Humanos , Hipóxia/sangue , Hipóxia/etiologia , Hipóxia/metabolismo , Imobilização , Inflamação/sangue , Inflamação/etiologia , Inflamação/metabolismo , /etiologia , /prevenção & controle , Infarto do Miocárdio/sangue , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/prevenção & controle , Guias de Prática Clínica como Assunto , Embolia Pulmonar/sangue , Embolia Pulmonar/etiologia , Embolia Pulmonar/metabolismo , Embolia Pulmonar/prevenção & controle , Índice de Gravidade de Doença , Trombocitopenia/sangue , Trombocitopenia/etiologia , Trombose/etiologia , Trombose/metabolismo , Trombose/prevenção & controle , Trombose Venosa/sangue , Trombose Venosa/etiologia , Trombose Venosa/metabolismo
9.
Medicine (Baltimore) ; 99(52): e23831, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350770

RESUMO

ABSTRACT: The International Society on Thrombosis and Haemostasis (ISTH) scoring system has been used for diagnosing overt disseminated intravascular coagulation (DIC). However, the cut-off points of fibrin-related markers remain unclear. The ability of the ISTH DIC score and Multiple Organ Dysfunction (MODS) score to predict mortality in cases of exertional heat illness (EHI) was tested. In the process, 3 different D-dimer cut-off values for diagnosing overt DIC were evaluated.Data were obtained on the first day of hospitalization for 76 patients with EHI. The DIC score was calculated according to the ISTH scoring system using 3 D-dimer cut-off values.In predicting mortality, methods 1 and 2 had the same sensitivity and specificity, which were 85% and 73.2%, respectively. The sensitivity for method 3 was 70%. Furthermore, the specificity of the DIC score for method 3 was 89%, which was higher than that of the other 2 methods. The correlation coefficients of the DIC and MODS scores of these 3 methods were 0.757, 0.748, and 0.756, respectively. For the prediction of mortality, the area under the receiver operating characteristic (ROC) curve for the DIC scores of these 3 methods was 0.838, 0.842, and 0.85, respectively. Furthermore, the area under the ROC curve of the MODS score was 0.927.The DIC score had a certain predictive power of a poor outcome of EHI patients, but this was not better than the MODS score. The present data may serve as a reference in selecting the appropriate D-dimer cut-off point for the ISTH DIC score.


Assuntos
Coagulação Intravascular Disseminada , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Transtornos de Estresse por Calor , Escores de Disfunção Orgânica , Adulto , China , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/diagnóstico , Feminino , Transtornos de Estresse por Calor/sangue , Transtornos de Estresse por Calor/diagnóstico , Transtornos de Estresse por Calor/mortalidade , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde/métodos , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Projetos de Pesquisa/normas , Sensibilidade e Especificidade
10.
Acta Cir Bras ; 35(11): e351102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331452

RESUMO

PURPOSE: In this experimental study, activated protein C (APC), which has anticoagulant, antithrombotic, profibrinolytic, anti-inflammatory and antiapoptotic properties, was used to prevent coagulopathy in a disseminated intravascular coagulation (DIC) model formatted with lipopolysaccharide (LPS) infusion. METHODS: Twenty-five Wistar albino rats weighting 280 - 320 g each were used. They were randomly divided into three groups: sham, control and study groups. To sham group (n = 5), only normal saline was infused. To control (n = 10) and study groups (n = 10), 30 mg/kg LPS was infused for 4 h from femoral vein. After LPS infusion, 100 µg/kg recombinant APC was given during 4 h in study group. Eight hours later, blood samples were taken from abdominal aorta and the animals sacrificed. From these samples, platelet, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer levels were studied. RESULTS: Platelet counts and fibrinogen levels were significantly lower in control and study groups than sham group (p < 0.05). The PT, aPTT and D-dimer levels were significantly higher in control and study groups than in sham group (p < 0.05). When comparing control and study groups, platelet counts were not statistically different (p = 0.36). However, the difference of the fibrinogen levels was significant between these groups (p = 0.0001). While PT and aPTT were longer in the study group compared to the control group (p < 0.05), D-dimer levels were lower in the study group than in control (p = 0.0001). CONCLUSION: Use of APC can prevent hypercoagulation and consumption coagulopathy in the DIC as a result of correcting hematological parameters other than prolongation of coagulation time.


Assuntos
Coagulação Intravascular Disseminada , Animais , Anticoagulantes , Coagulação Intravascular Disseminada/tratamento farmacológico , Lipopolissacarídeos , Proteína C , Ratos , Ratos Wistar
11.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 227-232, dic. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1145596

RESUMO

La enfermedad producida por el nuevo coronavirus SARS-CoV-2 se identificó por primera vez en diciembre de 2019 en la ciudad de Wuhan, en la República Popular China, y en pocos meses se convirtió en una pandemia. Desde el comienzo ha sido un desafío mundial, que amenazó la salud pública y obligó a tomar medidas estrictas de aislamiento social. Como consecuencia de la emergencia sanitaria se ha producido una reducción importante de la actividad asistencial, que puso en riesgo el acceso y la continuidad de los métodos anticonceptivos, exponiendo a mujeres a embarazos no intencionales. Los derechos sexuales y reproductivos resultan esenciales y deben garantizarse siempre. (AU)


The disease caused by the new coronavirus SARS-CoV-2 was identified for the first time in December 2019 in the city of Wuhan, in the People's Republic of China, and within a few months it became a pandemic. From the beginning, it has been a global challenge, threatening public health, having to take strict measures of social isolation. As a consequence of the health emergency, there has been a significant reduction in healthcare activity, putting access and continuity of contraceptive methods at risk, exposing women to unintended pregnancies. Sexual and reproductive rights are essential and must always be guaranteed. (AU)


Assuntos
Humanos , Feminino , Pneumonia Viral/complicações , Infecções por Coronavirus/complicações , Contracepção Hormonal/métodos , Pneumonia Viral/patologia , Gravidez não Desejada , Infecções por Coronavirus/patologia , Anticoncepcionais/administração & dosagem , Anticoncepcionais/classificação , Anticoncepcionais/provisão & distribução , Direitos Sexuais e Reprodutivos , Coagulação Intravascular Disseminada/etiologia , Tromboembolia Venosa/etiologia , Pandemias , Betacoronavirus , Acesso aos Serviços de Saúde
12.
Front Immunol ; 11: 583373, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33149733

RESUMO

Coronaviruses (CoVs) are members of the genus Betacoronavirus and the Coronaviridiae family responsible for infections such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and more recently, coronavirus disease-2019 (COVID-19). CoV infections present mainly as respiratory infections that lead to acute respiratory distress syndrome (ARDS). However, CoVs, such as COVID-19, also present as a hyperactivation of the inflammatory response that results in increased production of inflammatory cytokines such as interleukin (IL)-1ß and its downstream molecule IL-6. The inflammasome is a multiprotein complex involved in the activation of caspase-1 that leads to the activation of IL-1ß in a variety of diseases and infections such as CoV infection and in different tissues such as lungs, brain, intestines and kidneys, all of which have been shown to be affected in COVID-19 patients. Here we review the literature regarding the mechanism of inflammasome activation by CoV infection, the role of the inflammasome in ARDS, ventilator-induced lung injury (VILI), and Disseminated Intravascular Coagulation (DIC) as well as the potential mechanism by which the inflammasome may contribute to the damaging effects of inflammation in the cardiac, renal, digestive, and nervous systems in COVID-19 patients.


Assuntos
Caspase 1/metabolismo , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/patologia , Síndrome da Liberação de Citocina/patologia , Inflamassomos/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/patologia , Betacoronavirus/imunologia , Coagulação Intravascular Disseminada/patologia , Humanos , Inflamação/patologia , Interleucina-1beta/metabolismo , Pandemias , Síndrome Respiratória Aguda Grave/patologia , Lesão Pulmonar Induzida por Ventilação Mecânica/patologia
14.
Isr Med Assoc J ; 22(10): 613-617, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33070484

RESUMO

BACKGROUND: An association was shown between thrombocytosis and future development of several cancers. OBJECTIVES: To investigate whether pre-treatment platelet counts correlated with clinical outcomes of patients with breast cancer. METHODS: This retrospective study included 22 patients who had been diagnosed with stage I breast cancer and were 66.8 ± 13.2 years of age. Of these, 22 with stage II were 61.6 ± 12.3 years old and 9 with stage III and IV were 64.4 ± 15.3 years old. Clinical and hematological data from the first visit to the oncology clinic were collected. The follow-up period was 12 months to 5 years. RESULTS: A significant difference in platelet counts was found between patients who died (187,000 ± 4000 µ/L) and those who were disease free for 5 years (248,000 ± 83,000 µ/L, P = 0.0001). A significant difference in platelet-to-lymphocyte ratio was found between patients who died and those with recurrence (192 ± 81 vs. 124 ± 71, P = 0.01). A negative correlation was found between age and lymph nodes (Ps = -0.305, P = 0.02) and staging and white blood cells count (Ps = -0.280, P = 0.04). A positive correlation was found between clinical staging and lymph nodes (Ps = 0.443, P = 0.001) and clinical staging and metastases (P = 0.308, P = 0.02). CONCLUSIONS: Platelet counts may be a prognostic marker for breast cancer. Patients who died within 1 year had lower pre-treatment platelet count, which could represent an insidious disseminated intravascular coagulopathy cancer related consumption process.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Coagulação Intravascular Disseminada/epidemiologia , Trombocitose/epidemiologia , Idoso , Biomarcadores/análise , Plaquetas/fisiologia , Neoplasias da Mama/sangue , Estudos de Coortes , Comorbidade , Coagulação Intravascular Disseminada/sangue , Feminino , Humanos , Incidência , Israel , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Contagem de Plaquetas , Prognóstico , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida , Trombocitose/diagnóstico
15.
Mol Med ; 26(1): 97, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121429

RESUMO

BACKGROUND: COVID-19 is a viral respiratory disease caused by the severe acute respiratory syndrome-Coronavirus type 2 (SARS-CoV-2). Patients with this disease may be more prone to venous or arterial thrombosis because of the activation of many factors involved in it, including inflammation, platelet activation and endothelial dysfunction. Interferon gamma inducible protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein 1-alpha (MIP1α) are cytokines related to thrombosis. Therefore, this study focused on these three indicators in COVID-19, with the hope to find biomarkers that are associated with patients' outcome. METHODS: This is a retrospective single-center study involving 74 severe and critically ill COVID-19 patients recruited from the ICU department of the Tongji Hospital in Wuhan, China. The patients were divided into two groups: severe patients and critically ill patients. The serum IP-10, MCP-1 and MIP1α level in both groups was detected using the enzyme-linked immunosorbent assay (ELISA) kit. The clinical symptoms, laboratory test results, and the outcome of COVID-19 patients were retrospectively analyzed. RESULTS: The serum IP-10 and MCP-1 level in critically ill patients was significantly higher than that in severe patients (P < 0.001). However, no statistical difference in MIP1α between the two groups was found. The analysis of dynamic changes showed that these indicators remarkably increased in patients with poor prognosis. Since the selected patients were severe or critically ill, no significant difference was observed between survival and death. CONCLUSIONS: IP-10 and MCP-1 are biomarkers associated with the severity of COVID-19 disease and can be related to the risk of death in COVID-19 patients.


Assuntos
Quimiocina CCL2/sangue , Quimiocina CXCL10/sangue , Infecções por Coronavirus/complicações , Síndrome da Liberação de Citocina/complicações , Coagulação Intravascular Disseminada/complicações , Pneumonia Viral/complicações , Embolia Pulmonar/complicações , Insuficiência Respiratória/complicações , Proteínas Adaptadoras de Transdução de Sinal/sangue , Idoso , Betacoronavirus/patogenicidade , Biomarcadores/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Estado Terminal , Síndrome da Liberação de Citocina/diagnóstico , Síndrome da Liberação de Citocina/mortalidade , Síndrome da Liberação de Citocina/virologia , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/mortalidade , Coagulação Intravascular Disseminada/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Prognóstico , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/mortalidade , Embolia Pulmonar/virologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/mortalidade , Insuficiência Respiratória/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida
17.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1699-1703, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067977

RESUMO

OBJECTIVE: To investigate the diagnostic value of thromboelastography(TEG) for acute disseminated intravascular coagulation(DIC). METHODS: The clinical data and data of blood routine indexes, blood coagulation indexes and TEG indexes of acute 155 DIC patients were collected and analyzed retrospectively. RESULTS: The CDSS scores of DIC and non-DIC groups were 9.2±1.4 and 4.2±1.1 respectively, and the CDSS scores of DIC group was significantly higher than those in non-DIC group(P<0.05). The PLT level in DIC group was significantly lower than that in non-DIC group(P<0.05), the PT, APTT, INT, DD and FIB levels in DIC group were significantly higher than those in non-DIC group(P<0.05). The R time, K time and LY30 in DIC group were significantly higher than those in non-DIC group(P<0.05), and the α and MA in DIC group were significantly lower than those in non-DIC group(P<0.05). ROC curve analysis showed that the best cutoff value of R time, K time, α, MA and LY30 were 8.4 min, 6.2 min, 52.5°, 43.2 mm and 6.7% respectively. The AUC of total scores≥1, ≥2, ≥3 and ≥4 were 0.552, 0.650, 0.687 and 0.613 respectively. CONCLUSION: The TEG possesses the certain value in the diagnosing of DIC.


Assuntos
Coagulação Intravascular Disseminada , Tromboelastografia , Testes de Coagulação Sanguínea , Coagulação Intravascular Disseminada/diagnóstico , Humanos , Curva ROC , Estudos Retrospectivos
18.
Vascular ; 28(6): 705-707, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33045945

RESUMO

OBJECTIVES: Chronic disseminated intravascular coagulation is a rare complication of aortic dissection, and its optimal treatment remains controversial. METHODS: We present a 78-year-old man with repeated hemorrhagic events by disseminated intravascular coagulation due to chronic aortic dissection treated by thoracic endovascular aortic repair. RESULTS: Computed tomography angiography at three months revealed a completely thrombosed false lumen from the distal aortic arch to the descending aorta at the celiac artery level. Platelets and D-dimer levels remained stable, and the patient was doing well without hemorrhagic complications. CONCLUSIONS: Endovascular repair was effective for disseminated intravascular coagulation due to chronic type B aortic dissection.


Assuntos
Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Coagulação Intravascular Disseminada/etiologia , Procedimentos Endovasculares , Idoso , Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma da Aorta Torácica/complicações , Aneurisma da Aorta Torácica/diagnóstico por imagem , Prótese Vascular , Implante de Prótese Vascular/instrumentação , Doença Crônica , Coagulação Intravascular Disseminada/diagnóstico , Procedimentos Endovasculares/instrumentação , Humanos , Masculino , Stents , Resultado do Tratamento
19.
Medicina (B Aires) ; 80(5): 505-511, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-33048795

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic requires rapid medical responses. The risk of venous and arterial thromboembolism increases in critically ill patients with SARS-CoV-2 infection. There is a hypercoagulable state that includes elevated levels of D-dimer, with an increased risk of organ failure and increased mortality. The abnormalities described in hemostasis should be considered for therapeutic decision making. We analyzed the available scientific evidence for the therapeutic approach of coagulopathy in the course of the disease with the objective of designing realistic therapeutic recommendations aimed at reducing morbidity and mortality in patients with COVID-19.


Assuntos
Transtornos da Coagulação Sanguínea/etiologia , Infecções por Coronavirus/sangue , Coronavirus , Pandemias , Pneumonia Viral/sangue , Tromboembolia/complicações , Argentina/epidemiologia , Betacoronavirus , Transtornos da Coagulação Sanguínea/diagnóstico , Transtornos da Coagulação Sanguínea/epidemiologia , Transtornos da Coagulação Sanguínea/prevenção & controle , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Citocinas , Coagulação Intravascular Disseminada , Heparina , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Sepse
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA