Complete blood count, coagulation biomarkers, and lung function 6 months after critical COVID-19.

IF 1.9 4区 医学 Q2 ANESTHESIOLOGY
Acta Anaesthesiologica Scandinavica Pub Date : 2024-08-01 Epub Date: 2024-05-09 DOI:10.1111/aas.14437
Salla Kattainen, Hanna Pitkänen, Jere Reijula, Johanna Hästbacka
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引用次数: 0

Abstract

Background: Understanding the recovery of post-COVID-19 organ dysfunction is essential. We evaluated coagulation 6 months post-COVID-19, examining its recovery and association with lung function.

Methods: Patients treated for COVID-19 at intensive care units between 3/2020 and 1/2021 were analyzed for complete blood count (CBC) and coagulation biomarkers (prothrombin time activity (%) (PT%), activated partial thromboplastin time (APTT), fibrinogen, coagulation factor VIII (FVIII), antithrombin (AT), and D-dimer) during the 6 months post-hospitalization. Results were compared with acute phase values and correlated with pulmonary function tests (PFT), including forced vital capacity (FVC) and hemoglobin-corrected diffusing capacity percentage of predicted (DLCOc%), recorded 6 months post-hospitalization. We examined the association between coagulation biomarkers and DLCOc% using linear regression with age, sex, and invasive mechanical ventilation (IMV) duration, and FVIII (correlated with DLCOc%) as covariates.

Results: Most CBCs and coagulation biomarkers had median values within the normal range. However, only 21% (15/70) of patients achieved full normalization of all biomarkers. Compared to acute COVID-19, hemoglobin, PT%, and AT increased, while leukocytes, fibrinogen, FVIII, and D-dimer decreased. Despite decreased levels, FVIII remained elevated in 46% (31/68), leukocytes in 26% (18/70), and D-dimer in 27% (18/67) at 6 months. A weak negative correlation (r = -0.37, p = .036) was found between DLCOc% and FVIII. Multivariable analysis revealed a weak, independent association between DLCOc% and FVIII. Excluding patients with anticoagulation therapy, FVIII no longer correlated with DLCOc%, while AT showed a moderate correlation with DLCOc%.

Conclusion: Only a few patients had normal CBC and coagulation biomarker values 6 months after critical COVID-19. A weak negative correlation between DLCOc% and FVIII suggests that deranged coagulation activity may be associated with reduced diffusing capacity.

COVID-19 重症监护 6 个月后的全血细胞计数、凝血生物标志物和肺功能。
背景:了解 COVID-19 后器官功能障碍的恢复情况至关重要。我们对 COVID-19 后 6 个月的凝血功能进行了评估,研究其恢复情况及其与肺功能的关系:方法:我们对 2020 年 3 月至 2021 年 1 月期间在重症监护病房接受 COVID-19 治疗的患者住院后 6 个月期间的全血细胞计数(CBC)和凝血生物标志物(凝血酶原时间活性(%)(PT%)、活化部分凝血活酶时间(APTT)、纤维蛋白原、凝血因子 VIII(FVIII)、抗凝血酶(AT)和 D-二聚体)进行了分析。结果与急性期值进行了比较,并与入院后 6 个月记录的肺功能测试(PFT)(包括用力肺活量(FVC)和血红蛋白校正弥散能力占预测值百分比(DLCOc%))相关。我们以年龄、性别、有创机械通气(IMV)持续时间和 FVIII(与 DLCOc% 相关)为协变量,采用线性回归法研究了凝血生物标志物与 DLCOc% 之间的关联:大多数全血细胞计数和凝血生物标志物的中位值在正常范围内。然而,只有 21% 的患者(15/70)实现了所有生物标志物的完全正常化。与急性 COVID-19 相比,血红蛋白、PT% 和 AT 增加,而白细胞、纤维蛋白原、FVIII 和 D-二聚体减少。尽管水平有所下降,但在 6 个月时,46%(31/68)的 FVIII、26%(18/70)的白细胞和 27%(18/67)的 D-二聚体仍然升高。DLCOc% 和 FVIII 之间呈弱负相关(r = -0.37,p = 0.036)。多变量分析显示 DLCOc% 和 FVIII 之间存在微弱的独立关联。排除接受抗凝治疗的患者,FVIII 与 DLCOc% 不再相关,而 AT 与 DLCOc% 呈中度相关:结论:COVID-19危重症6个月后,只有少数患者的全血细胞计数和凝血生物标志物值正常。DLCOc%与FVIII之间的微弱负相关表明,凝血活动失调可能与弥散能力降低有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.30
自引率
9.50%
发文量
157
审稿时长
3-8 weeks
期刊介绍: Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.
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