Altered platelet and coagulation function in moderate-to-severe COVID-19

Abstract To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, di...

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Autores principales:	Rustem I. Litvinov, Natalia G. Evtugina, Alina D. Peshkova, Svetlana I. Safiullina, Izabella A. Andrianova, Alina I. Khabirova, Chandrasekaran Nagaswami, Rafael R. Khismatullin, Svetlana S. Sannikova, John W. Weisel
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/036bc870feca4d6084489ea709a4889d
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spelling	oai:doaj.org-article:036bc870feca4d6084489ea709a4889d2021-12-02T19:06:40ZAltered platelet and coagulation function in moderate-to-severe COVID-1910.1038/s41598-021-95397-62045-2322https://doaj.org/article/036bc870feca4d6084489ea709a4889d2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95397-6https://doaj.org/toc/2045-2322Abstract To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease severity, comorbidities, and mortality risk. The prolonged clotting tests in about ¼ of cases were associated with high levels of C-reactive protein and antiphospholipid antibodies, which impeded coagulation in vitro. Contraction of blood clots was hindered in about ½ of patients, especially in severe and fatal cases, and correlated directly with prothrombotic parameters. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with platelet dysfunction. Clots with impaired contraction were porous, had a low content of compressed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin, suggesting that the uncompacted intravital clots are more obstructive but patients could also be prone to bleeding. The absence of consumption coagulopathy suggests the predominance of local and/or regional microthrombosis rather than disseminated intravascular coagulation. The results obtained (i) confirm the importance of hemostatic disorders in COVID-19 and their relation to systemic inflammation; (ii) justify monitoring of hemostasis, including the kinetics of blood clot contraction; (iii) substantiate the active prophylaxis of thrombotic complications in COVID-19.Rustem I. LitvinovNatalia G. EvtuginaAlina D. PeshkovaSvetlana I. SafiullinaIzabella A. AndrianovaAlina I. KhabirovaChandrasekaran NagaswamiRafael R. KhismatullinSvetlana S. SannikovaJohn W. WeiselNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rustem I. Litvinov Natalia G. Evtugina Alina D. Peshkova Svetlana I. Safiullina Izabella A. Andrianova Alina I. Khabirova Chandrasekaran Nagaswami Rafael R. Khismatullin Svetlana S. Sannikova John W. Weisel Altered platelet and coagulation function in moderate-to-severe COVID-19
description	Abstract To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease severity, comorbidities, and mortality risk. The prolonged clotting tests in about ¼ of cases were associated with high levels of C-reactive protein and antiphospholipid antibodies, which impeded coagulation in vitro. Contraction of blood clots was hindered in about ½ of patients, especially in severe and fatal cases, and correlated directly with prothrombotic parameters. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with platelet dysfunction. Clots with impaired contraction were porous, had a low content of compressed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin, suggesting that the uncompacted intravital clots are more obstructive but patients could also be prone to bleeding. The absence of consumption coagulopathy suggests the predominance of local and/or regional microthrombosis rather than disseminated intravascular coagulation. The results obtained (i) confirm the importance of hemostatic disorders in COVID-19 and their relation to systemic inflammation; (ii) justify monitoring of hemostasis, including the kinetics of blood clot contraction; (iii) substantiate the active prophylaxis of thrombotic complications in COVID-19.
format	article
author	Rustem I. Litvinov Natalia G. Evtugina Alina D. Peshkova Svetlana I. Safiullina Izabella A. Andrianova Alina I. Khabirova Chandrasekaran Nagaswami Rafael R. Khismatullin Svetlana S. Sannikova John W. Weisel
author_facet	Rustem I. Litvinov Natalia G. Evtugina Alina D. Peshkova Svetlana I. Safiullina Izabella A. Andrianova Alina I. Khabirova Chandrasekaran Nagaswami Rafael R. Khismatullin Svetlana S. Sannikova John W. Weisel
author_sort	Rustem I. Litvinov
title	Altered platelet and coagulation function in moderate-to-severe COVID-19
title_short	Altered platelet and coagulation function in moderate-to-severe COVID-19
title_full	Altered platelet and coagulation function in moderate-to-severe COVID-19
title_fullStr	Altered platelet and coagulation function in moderate-to-severe COVID-19
title_full_unstemmed	Altered platelet and coagulation function in moderate-to-severe COVID-19
title_sort	altered platelet and coagulation function in moderate-to-severe covid-19
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/036bc870feca4d6084489ea709a4889d
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Altered platelet and coagulation function in moderate-to-severe COVID-19

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