Derivation and Validation of a Predictive Score for Disease Worsening Inpatients with COVID-19
In: Blood, 2020
academicJournal
Zugriff:
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease. COVID-19 is associated with excessive inflammation, platelet activation, endothelial dysfunction, blood coagulation activation and fibrin formation. Current management of patients hospitalized in an intensive care unit (ICU) is based on supportive care and the mortality rate is high. Blood hypercoagulability -documented by increase in D-Dimers and decrease in antithrombin (AT) -is frequently encountered among COVID-19 patients. Aim: Identification of patients with COVID-19 being at high risk for clinical deterioration is a challenging issue for an earlier adapted treatment and positive clinical outcome. we aimed to identify the most relevant clinical and haematological risk factors for worsening of COVID-19 in hospitalized patients by and constructing an accurate risk assessment tool, COMPASS-COVID-19. Methods: Patients with confirmed COVID-19 (n=430) were divided in derivation (n=310) and validation (n=120) cohorts. They were stratified to those hospitalized at the conventional ward (C-group) and those with worsening disease (W-group) admitted in ICU. The study endpoint was disease worsening. All patients were routinely evaluated with full blood count, prothrombin time, fibrinogen, D-Dimers, antithrombin and protein C activity. Data from the first hospitalization day at the conventional ward or the ICU were analyzed. Cardiovascular risk factors and comorbidities were routinely registered. Results: In the derivation cohort, compensated DIC was diagnosed in 8.2% of patients in the C-group and in 28.2% of patients in the W-group (p=0.001). Compared to the C-group, the patients in the W-group had significantly lower levels of AT, PC, platelets, lymphocyte, monocyte and red blood cell counts as well as, hemoglobin and hematocrit. They had significantly higher levels of fibrinogen, DDimers, white blood cells and neutrophils counts. No difference was noted in eosinophil and basophil counts. Hematological predictors ...
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Derivation and Validation of a Predictive Score for Disease Worsening Inpatients with COVID-19
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Autor/in / Beteiligte Person: | Gerotziafas, Grigoris ; Van Dreden, Patrick ; Papageorgiou, Loula ; Sergentanis, Theodoros N ; Dimopoulos, Meletios-Athanasios ; Elalamy, Ismail |
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Zeitschrift: | Blood, 2020 |
Veröffentlichung: | American Society of Hematology. Published by Elsevier Inc., 2020 |
Medientyp: | academicJournal |
DOI: | 10.1182/blood-2020-136528 |
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