학술논문

Disseminated Intravascular Coagulation Score and Sepsis-induced Coagulopathy Score in Prediction of COVID-19 Severity: A Retrospective Analysis.
Document Type
Article
Source
Indian Journal of Critical Care Medicine. Dec2021, Vol. 25 Issue 12, p1357-1363. 7p. 1 Diagram, 8 Charts, 1 Graph.
Subject
*DISSEMINATED intravascular coagulation
*PROTHROMBIN time
*COVID-19
*PREDICTIVE tests
*RETROSPECTIVE studies
*ACQUISITION of data
*SEVERITY of illness index
*SEPSIS
*BLOOD coagulation disorders
*MEDICAL records
*DESCRIPTIVE statistics
*PLATELET count
*FIBRINOGEN
*INTERNATIONAL normalized ratio
*FIBRIN fibrinogen degradation products
*EVALUATION
Language
ISSN
0972-5229
Abstract
Background: The novel disseminated intravascular coagulation (DIC) score (platelet count, prolonged prothrombin time, D-dimer, and fibrinogen) and sepsis-induced coagulopathy (SIC) score (platelet count, international normalized ratio, and sequential organ failure assessment score) are markers of coagulopathy, which, for the first time, are explored in line with the coronavirus disease-2019 (COVID-19) disease outcomes. The correlation of D-dimer with these findings is also studied. Materials and methods: A retrospective analysis of hospital-based records of 168 COVID-19 patients was done. Data including D-dimer, routine investigations, DIC, and SIC scorings (all within 3 days of admission) were collected and correlated with the outcomes. The study was conducted in a tertiary care center catering to North India's population. Results: Higher DIC score (1.59 ± 1.18 vs 0.96 ± 1.18), SIC score (1.60 ± 0.89 vs 0.63 ± 0.99), and D-dimer titers (1321.33 ± 1627.89 vs 583·66 ± 777.71 ng/mL) were significantly associated with severe COVID-19 disease (p <0.05). DIC score and SIC score ≥1, and D-dimer ≥1315 ng/mL for severe disease; DIC score ≥1, SIC score ≥2, and D-dimer ≥600 ng/mL for pulmonary embolism (PE); and DIC score and SIC score ≥1, and D-dimer level ≥990 ng/mL for mortality were the respective cutoff values we found from our study. Conclusion: Higher DIC scores, SIC scores, and D-dimer values are associated with severe COVID-19 disease, inhospital mortality, and PE risk. They can serve as easily accessible early markers of severe disease and prioritize hospital admissions in the presently overburdened scenario and may be used to develop prognostic prediction models. [ABSTRACT FROM AUTHOR]