Introduction: Aim of the study is to assess the occurrence of early stage coagulopathy and disseminated intravascular coagulation (DIC) in patients with mild to moderate respiratory distress secondary to SARS-CoV-2 infection. Materials and methods: Data of patients hospitalized from 18 March 2020 to 20 April 2020 were retrospectively reviewed. Two scores for the screening of coagulopathy (SIC and non-overt DIC scores) were calculated. The occurrence of thrombotic complication, death, and worsening respiratory function requiring non-invasive ventilation (NIV) or admission to ICU were recorded, and these outcomes were correlated with the results of each score. Chi-square test, receiver-operating characteristic curve, and logistic regression analysis were used as appropriate.pValues < 0.05 were considered statistically significant. Results: Data of 32 patients were analyzed. Overt-DIC was diagnosed in two patients (6.2%), while 26 (81.2%) met the criteria for non-overt DIC. Non-overt DIC score values >= 4 significantly correlated with the need of NIV/ICU (p= 0.02) and with the occurrence of thrombotic complications (p= 0.04). A score >= 4 was the optimal cut-off value, performing better than SIC score (p= 0.0018). Values >= 4 in patients with thrombotic complications were predictive of death (p= 0.03). Conclusions: Overt DIC occurred in 6.2% of non-ICU patients hospitalized for a mild to moderate COVID-19 respiratory distress, while 81.2% fulfilled the criteria for non-overt DIC. The non-overt DIC score performed better than the SIC score in predicting the need of NIV/ICU and the occurrence of thrombotic complications, as well as in predicting mortality in patients with thrombotic complications, with a score >= 4 being detected as the optimal cut-off.

Non-Overt Coagulopathy in Non-ICU Patients with Mild to Moderate COVID-19 Pneumonia / D. Mazzaccaro, F. Giacomazzi, M. Giannetta, A. Varriale, R. Scaramuzzo, A. Modafferi, G. Malacrida, P. Righini, M.M. Marrocco-Trischitta, G. Nano. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 9:6(2020), pp. 1781.1-1781.12. [10.3390/jcm9061781]

Non-Overt Coagulopathy in Non-ICU Patients with Mild to Moderate COVID-19 Pneumonia

D. Mazzaccaro;M. Giannetta;A. Varriale;G. Nano
2020

Abstract

Introduction: Aim of the study is to assess the occurrence of early stage coagulopathy and disseminated intravascular coagulation (DIC) in patients with mild to moderate respiratory distress secondary to SARS-CoV-2 infection. Materials and methods: Data of patients hospitalized from 18 March 2020 to 20 April 2020 were retrospectively reviewed. Two scores for the screening of coagulopathy (SIC and non-overt DIC scores) were calculated. The occurrence of thrombotic complication, death, and worsening respiratory function requiring non-invasive ventilation (NIV) or admission to ICU were recorded, and these outcomes were correlated with the results of each score. Chi-square test, receiver-operating characteristic curve, and logistic regression analysis were used as appropriate.pValues < 0.05 were considered statistically significant. Results: Data of 32 patients were analyzed. Overt-DIC was diagnosed in two patients (6.2%), while 26 (81.2%) met the criteria for non-overt DIC. Non-overt DIC score values >= 4 significantly correlated with the need of NIV/ICU (p= 0.02) and with the occurrence of thrombotic complications (p= 0.04). A score >= 4 was the optimal cut-off value, performing better than SIC score (p= 0.0018). Values >= 4 in patients with thrombotic complications were predictive of death (p= 0.03). Conclusions: Overt DIC occurred in 6.2% of non-ICU patients hospitalized for a mild to moderate COVID-19 respiratory distress, while 81.2% fulfilled the criteria for non-overt DIC. The non-overt DIC score performed better than the SIC score in predicting the need of NIV/ICU and the occurrence of thrombotic complications, as well as in predicting mortality in patients with thrombotic complications, with a score >= 4 being detected as the optimal cut-off.
disseminated intravascular coagulation; DIC; COVID-19; respiratory distress
Settore MED/22 - Chirurgia Vascolare
2020
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/769009
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