Coagulopatía inducida por COVID-19, de la bibliografía a la práctica clínica
Rev Hematol Mex. 2023; 24 (3): 128-135. https://doi.org/10.24245/rev_hematol.v24i3.9165
Bruno Samaniego Segovia,1 César Alejandro Rodríguez Salinas,1 Arnulfo González Cantú,2 Jorge Luis Montemayor Montoya,3 Diego Jaime Villalón,4 Cosette De la Mora5
1 Internal Medicine Resident
2 Internal Medicine Physician. Clinical Endocrinologist.
3 Internal Medicine Physician. Clinical Haematologist. Clinical Professor of the Internal Medicine Residency.
4 Internal Medicine Physician. Clinical Infectious Disease Specialist.
5 Medical Intern.
Christus Muguerza Health Systems, UDEM, Monterrey, Nuevo León, México.
Abstract
OBJECTIVE: To determine the clinical practice of the intentional search of COVID-19 induced coagulopathy at hospital admission and describe its incidence, thrombosis rates and mortality.
MATERIALS AND METHODS: A retrospective cohort study of adult patients with COVID-19 that required hospitalization was made from April 2020 to May 2021 in a Mexican private hospital. COVID-19 induced coagulopathy diagnosis was established if two of these criteria were met: D-dimer above 1 µg/mL, platelet count below 150 K/µL and international normalized ratio (INR) of 1.2 or higher. The population was divided according to therapy: thromboprophylaxis, anticoagulation vs not-to-treat. General characteristics, mortality, length of stay, and thrombosis rates were described for each group.
RESULTS: For a total of 532 patients, 116 were evaluable for COVID-19 induced coagulopathy at hospital admission; the diagnosis was confirmed in 34 of them (29.3%). The thrombosis rates and mortality were 17.6% and 32.3%, respectively. Those who received anticoagulation presented with more severe clinical and biochemical characteristics, hence the length of stay and thrombosis rates were higher in them.
CONCLUSIONS: The diagnosis of COVID-19 induced coagulopathy reached 29.3% in the evaluable population. Its search is close to 21.8% of the patients admitted.
KEYWORDS: Coagulopathy; COVID-19; Thrombosis; Anticoagulation.
Resumen
OBJETIVO: Determinar la práctica clínica de la búsqueda intencional de coagulopatía inducida por COVID-19 al ingreso hospitalario y describir su incidencia, tasas de trombosis y mortalidad.
MATERIALES Y MÉTODOS: Estudio de cohorte retrospectivo de pacientes adultos con COVID-19 que requirieron hospitalización, efectuado de abril de 2020 a mayo de 2021 en un hospital privado mexicano. El diagnóstico de coagulopatía inducida por COVID-19 se estableció si se cumplían dos de estos criterios: dímero D superior a 1 µg/mL, recuento de plaquetas inferior a 150 K/µL e índice internacional normalizado (INR) de 1.2 o superior. La población se dividió según el tratamiento: tromboprofilaxis, anticoagulación versus sin tratamiento. Para cada grupo se describieron las características generales, la mortalidad, la duración de la estancia hospitalaria y las tasas de trombosis.
RESULTADOS: De un total de 532 pacientes, 116 fueron evaluables para coagulopatía inducida por COVID-19 al ingreso hospitalario; el diagnóstico se confirmó en 34 de ellos (29.3%). Las tasas de trombosis y mortalidad fueron del 17.6 y 32.3%, respectivamente. Los pacientes que recibieron anticoagulación mostraron características clínicas y bioquímicas más graves, de ahí que la estancia hospitalaria y las tasas de trombosis fueran mayores en ellos.
CONCLUSIONES: El diagnóstico de coagulopatía inducida por COVID-19 alcanzó el 29.3% en la población evaluable. Su búsqueda se acerca al 21.8% de los pacientes ingresados.
PALABRAS CLAVE: Coagulopatía; COVID-19; trombosis; anticoagulación.
Received: September 2023
Accepted: September 2023
This article must be quoted: Samaniego-Segovia B, Rodríguez-Salinas CA, González-Cantú A, Montemayor-Montoya JL, Jaime-Villalón D, De la Mora C. Approach of COVID-19 induced coagulopathy, from literature to the clinical practice. Hematol Méx 2023; 24 (3): 128-135.
