Compromised Lung Volume and Hemostatic Abnormalities in COVID-19 Pneumonia: Results from an Observational Study on 510 Consecutive Patients.
COVID-19
D-dimer
SARS-CoV-2 pneumonia
hemostasis
lung volume measurements
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
29 Jun 2021
29 Jun 2021
Historique:
received:
31
05
2021
revised:
18
06
2021
accepted:
20
06
2021
entrez:
2
7
2021
pubmed:
3
7
2021
medline:
3
7
2021
Statut:
epublish
Résumé
Hemostatic abnormalities have been described in COVID-19, and pulmonary microthrombosis was consistently found at autopsy with concomitant severe lung damage. This is a retrospective observational cross-sectional study including consecutive patients with COVID-19 pneumonia who underwent unenhanced chest CT upon admittance at the emergency room (ER) in one large academic hospital. QCT was used for the calculation of compromised lung volume (%CL). Clinical data were retrieved from patients' files. Laboratory data were obtained upon presentation at the ER. The aim of this study was to evaluate the correlation between hemostatic abnormalities and lung involvement in patients affected by COVID-19 pneumonia as described using computer-aided quantitative evaluation of chest CT (quantitative CT (QCT)). A total of 510 consecutive patients (68% males), aged 67 years in median, diagnosed with COVID-19 pneumonia, who underwent unenhanced CT scan upon admission to the ER, were included. In all, 115 patients had %CL > 23%; compared to those with %CL < 23%, they showed higher levels of D-dimer, fibrinogen, and CRP, greater platelet count, and longer PT ratio. Via multivariate regression analysis, BMI ≥ 30 kg/m Hemostatic abnormalities in patients affected by COVID-19 correlate with the severity of lung injury as measured by %CL. Our results underline the pathogenetic role of hemostasis in COVID-19 pneumonia beyond the presence of clinically evident thromboembolic complications.
Sections du résumé
BACKGROUND
BACKGROUND
Hemostatic abnormalities have been described in COVID-19, and pulmonary microthrombosis was consistently found at autopsy with concomitant severe lung damage.
METHODS
METHODS
This is a retrospective observational cross-sectional study including consecutive patients with COVID-19 pneumonia who underwent unenhanced chest CT upon admittance at the emergency room (ER) in one large academic hospital. QCT was used for the calculation of compromised lung volume (%CL). Clinical data were retrieved from patients' files. Laboratory data were obtained upon presentation at the ER.
AIM
OBJECTIVE
The aim of this study was to evaluate the correlation between hemostatic abnormalities and lung involvement in patients affected by COVID-19 pneumonia as described using computer-aided quantitative evaluation of chest CT (quantitative CT (QCT)).
RESULTS
RESULTS
A total of 510 consecutive patients (68% males), aged 67 years in median, diagnosed with COVID-19 pneumonia, who underwent unenhanced CT scan upon admission to the ER, were included. In all, 115 patients had %CL > 23%; compared to those with %CL < 23%, they showed higher levels of D-dimer, fibrinogen, and CRP, greater platelet count, and longer PT ratio. Via multivariate regression analysis, BMI ≥ 30 kg/m
CONCLUSIONS
CONCLUSIONS
Hemostatic abnormalities in patients affected by COVID-19 correlate with the severity of lung injury as measured by %CL. Our results underline the pathogenetic role of hemostasis in COVID-19 pneumonia beyond the presence of clinically evident thromboembolic complications.
Identifiants
pubmed: 34209720
pii: jcm10132894
doi: 10.3390/jcm10132894
pmc: PMC8268714
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Quant Imaging Med Surg. 2020 Sep;10(9):1852-1862
pubmed: 32879862
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
J Thromb Haemost. 2020 Jul;18(7):1747-1751
pubmed: 32302448
PLoS One. 2018 Nov 26;13(11):e0207959
pubmed: 30475907
Thromb Haemost. 2001 Nov;86(5):1327-30
pubmed: 11816725
J Thromb Thrombolysis. 2020 Nov;50(4):825-832
pubmed: 32761495
Eur Radiol. 2020 Dec;30(12):6770-6778
pubmed: 32591888
Thromb Res. 2020 Jul;191:9-14
pubmed: 32353746
Radiology. 2020 Sep;296(3):E189-E191
pubmed: 32324102
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Radiology. 2020 Aug;296(2):E86-E96
pubmed: 32301647
Lancet Haematol. 2020 Jun;7(6):e438-e440
pubmed: 32407672
Eur Respir J. 2020 Oct 29;56(4):
pubmed: 32943402
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Cardiovasc Res. 2020 Dec 1;116(14):2239-2246
pubmed: 32637999
Blood Coagul Fibrinolysis. 2007 Mar;18(2):179-86
pubmed: 17287636
J Thromb Haemost. 2020 Apr;18(4):844-847
pubmed: 32073213
Crit Care. 2013 May 24;17(3):R93
pubmed: 23706034
Blood. 2020 Jun 4;135(23):2033-2040
pubmed: 32339221
Radiology. 2020 Sep;296(3):E186-E188
pubmed: 32324103
Ann Intern Med. 2020 Aug 18;173(4):268-277
pubmed: 32374815
Thromb Res. 2020 Nov;195:219-225
pubmed: 32777639
PLoS One. 2019 Mar 21;14(3):e0214278
pubmed: 30897161
J Clin Med. 2020 May 07;9(5):
pubmed: 32392741
J Clin Med. 2020 May 20;9(5):
pubmed: 32443899
J Am Coll Cardiol. 2020 Jun 16;75(23):2950-2973
pubmed: 32311448
Semin Thromb Hemost. 2020 Oct;46(7):777-780
pubmed: 32396963
Cardiol Rev. 2020 Nov/Dec;28(6):295-302
pubmed: 33017364
Med Phys. 2019 Sep;46(9):3985-3997
pubmed: 31206181
Blood. 2020 Jul 23;136(4):489-500
pubmed: 32492712