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Book ; Online: Problemas de coagulación y trombos en pacientes con COVID-19

Coiras, Mayte / Meijón Ortigueira, Maria del Mar / Jiménez Yuste, Victor / Grupo de Análisis Científico de Coronavirus del ISCIII (GACC-ISCIII)

2020

Abstract: ... en la coagulación de la sangre, denominados Coagulopatía asociada a COVID-19. Este cuadro genera un estado protrombótico debido a ... Debido a esto es importante realizar una valoración integral de los pacientes considerando sus antecedentes ... el tratamiento y el seguimiento en estos pacientes. El empleo de la profilaxis antitrombótica debe ser valorado ...

Abstract	Este informe está realizado con la evidencia científica disponible en la fecha de su elaboración y podrá ser actualizado si surgen nuevas evidencias La infección por coronavirus SARS-CoV-2 puede causar diversas manifestaciones clínicas, entre las que se encuentran trastornos en la coagulación de la sangre, denominados Coagulopatía asociada a COVID-19. Este cuadro genera un estado protrombótico debido a la lesión de las células endoteliales de los vasos sanguíneos, bien por efecto directo del propio virus o bien a través de una reacción inflamatoria en respuesta a proteínas del complemento o mediadores de la respuesta inmune. Entre las posibles consecuencias clínicas de este proceso destaca la potencial aparición de trombosis, entre las que se incluyen principalmente la embolia pulmonar o la trombosis venosa profunda. Debido a esto es importante realizar una valoración integral de los pacientes considerando sus antecedentes personales y familiares, e identificando patologías de base tales como enfermedades cardiovasculares, hipertensión, diabetes u obesidad, que favorecen la aparición de eventos trombóticos. Esta información debe correlacionarse con los parámetros clínicos, analíticos y radiológicos para optimizar en la medida de lo posible el tratamiento y el seguimiento en estos pacientes. El empleo de la profilaxis antitrombótica debe ser valorado considerando el riesgo trombótico y hemorrágico en cada paciente, así como los factores de riesgo asociados; es importante además realizar una adecuada monitorización en estos casos. No
Keywords	Coronavirus ; COVID-19 ; SARS- Cov_2 ; Investigación en salud ; Coagulación ; Trombos ; covid19
Language	Spanish
Publishing date	2020-06-16
Publishing country	es
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: [Association between cardio-ankle vascular index and markers of thrombosis in hospitalized patients COVID-19].

Podzolkov, V I / Bragina, A E / Tarzimanova, A I / Ogibenina, E S / Shvedov, I I / Ivannikov, A A / Megeneishvili, N К / Sutulova, A V

Terapevticheskii arkhiv

2023 Volume 95, Issue 7, Page(s) 548–553

Abstract: ... of procoagulant state - D-dimer in hospitalized patients with coronavirus disease 2019 (COVID-19).: Materials ... with clinically diagnosed or laboratory-confirmed COVID-19. We compared groups of patients with normal and ... with elevated D-dimer levels in patients with COVID-19. In a multivariate logistic regression, CAVI above 9.5 ...

Abstract	Aim: To evaluate the relationship between the cardio-ankle vascular index (CAVI) and the marker of procoagulant state - D-dimer in hospitalized patients with coronavirus disease 2019 (COVID-19). Materials and methods: This cross-sectional study involved adult patients admitted to the University hospital with clinically diagnosed or laboratory-confirmed COVID-19. We compared groups of patients with normal and elevated CAVI. Univariate and multivariate logistic regression analyses were performed to assess the association between risk factors and elevated D-dimer levels; odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated to determine the strength of association. A Results: The study included 152 patients [64 (42.1%) men and 88 (57.9%) women], mean age 59.10±12.74 years. 45 (29.6%) had elevated CAVI. Patients with elevated CAVI were older, had more comorbid diseases, a higher Charlson comorbidity index and D-dimer levels. Age, the comorbidity index, and CAVI above 9.5 were associated with elevated D-dimer levels in patients with COVID-19. In a multivariate logistic regression, CAVI above 9.5 was an independent predictor of increased D-dimer in patients with COVID-19 (OR 2.513, 95% CI 1.050-6.012; Conclusion: In this study, for the first time, the association between a vascular stiffness marker, elevated CAVI, and increased D-dimer levels in COVID-19 patients was shown. This relationship may be a consequence of endothelial dysfunction and can be used as an additional marker of coagulopathy developing as part of COVID-19.
MeSH term(s)	Male ; Adult ; Humans ; Female ; Middle Aged ; Aged ; Cross-Sectional Studies ; Ankle/blood supply ; COVID-19/complications ; COVID-19/diagnosis ; Risk Factors ; Thrombosis/diagnosis ; Thrombosis/epidemiology ; Thrombosis/etiology ; Vascular Stiffness ; Ankle Brachial Index
Language	Russian
Publishing date	2023-09-29
Publishing country	Russia (Federation)
Document type	English Abstract ; Journal Article
ZDB-ID	40718-5
ISSN	2309-5342 ; 0040-3660
ISSN (online)	2309-5342
ISSN	0040-3660
DOI	10.26442/00403660.2023.07.202292
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Article ; Online: Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination.

Schultz, Nina H / Sørvoll, Ingvild H / Michelsen, Annika E / Munthe, Ludvig A / Lund-Johansen, Fridtjof / Ahlen, Maria T / Wiedmann, Markus / Aamodt, Anne-Hege / Skattør, Thor H / Tjønnfjord, Geir E / Holme, Pål A

The New England journal of medicine

2021 Volume 384, Issue 22, Page(s) 2124–2130

Abstract: ... coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age ... to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against ... We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 ...

Abstract	We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4-polyanion complexes; however, they had had no previous exposure to heparin. Because the five cases occurred in a population of more than 130,000 vaccinated persons, we propose that they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia that we refer to as vaccine-induced immune thrombotic thrombocytopenia.
MeSH term(s)	Adult ; Autoantibodies/blood ; Autoimmune Diseases/etiology ; Blood Chemical Analysis ; COVID-19 Vaccines/adverse effects ; ChAdOx1 nCoV-19 ; Enzyme-Linked Immunosorbent Assay ; Fatal Outcome ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation ; Platelet Count ; Platelet Factor 4/immunology ; Thrombocytopenia/etiology ; Thrombosis/etiology
Chemical Substances	Autoantibodies ; COVID-19 Vaccines ; Platelet Factor 4 (37270-94-3) ; ChAdOx1 nCoV-19 (B5S3K2V0G8)
Language	English
Publishing date	2021-04-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMoa2104882
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Article ; Online: Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C.

Blood

2021 Volume 138, Issue 2, Page(s) 190–198

Abstract: ... thrombosis in children and adolescents is unclear. Most children with acute COVID-19 have mild disease ... in children hospitalized with COVID-19 or MIS-C and evaluate associated risk factors. We classified patients into 1 of 3 ... In patients with COVID-19 or MIS-C, a majority of TEs (89%) occurred in patients age ≥12 years. Patients age ...

Abstract	Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with thrombotic complications in adults, but the incidence of COVID-19-related thrombosis in children and adolescents is unclear. Most children with acute COVID-19 have mild disease, but coagulopathy has been associated with multisystem inflammatory syndrome in children (MIS-C), a postinfectious complication. We conducted a multicenter retrospective cohort study to determine the incidence of thrombosis in children hospitalized with COVID-19 or MIS-C and evaluate associated risk factors. We classified patients into 1 of 3 groups for analysis: COVID-19, MIS-C, or asymptomatic SARS-CoV-2. Among a total of 853 admissions (COVID-19, n = 426; MIS-C, n = 138; and asymptomatic SARS-CoV-2, n = 289) in 814 patients, there were 20 patients with thrombotic events (TEs; including 1 stroke). Patients with MIS-C had the highest incidence (9 [6.5%] of 138) vs COVID-19 (9 [2.1%] of 426) or asymptomatic SARS-CoV-2 (2 [0.7%] of 289). In patients with COVID-19 or MIS-C, a majority of TEs (89%) occurred in patients age ≥12 years. Patients age ≥12 years with MIS-C had the highest rate of thrombosis at 19% (9 of 48). Notably, 71% of TEs that were not present on admission occurred despite thromboprophylaxis. Multivariable analysis identified the following as significantly associated with thrombosis: age ≥12 years, cancer, presence of a central venous catheter, and MIS-C. In patients with COVID-19 or MIS-C, hospital mortality was 2.3% (13 of 564), but it was 28% (5 of 18) in patients with TEs. Our findings may help inform pediatric thromboprophylaxis strategies.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Anticoagulants/therapeutic use ; COVID-19/complications ; COVID-19/diagnosis ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Risk Factors ; SARS-CoV-2/isolation & purification ; Systemic Inflammatory Response Syndrome/complications ; Systemic Inflammatory Response Syndrome/diagnosis ; Thrombosis/drug therapy ; Thrombosis/etiology ; Thrombosis/prevention & control ; Young Adult
Chemical Substances	Anticoagulants
Language	English
Publishing date	2021-04-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80069-7
ISSN	1528-0020 ; 0006-4971
ISSN (online)	1528-0020
ISSN	0006-4971
DOI	10.1182/blood.2020010218
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Article ; Online: Altered fibrin clot structure and dysregulated fibrinolysis contribute to thrombosis risk in severe COVID-19.

Wygrecka, Malgorzata / Birnhuber, Anna / Seeliger, Benjamin / Michalick, Laura / Pak, Oleg / Schultz, Astrid-Solveig / Schramm, Fabian / Zacharias, Martin / Gorkiewicz, Gregor / David, Sascha / Welte, Tobias / Schmidt, Julius J / Weissmann, Norbert / Schermuly, Ralph T / Barreto, Guillermo / Schaefer, Liliana / Markart, Philipp / Brack, Markus C / Hippenstiel, Stefan /

Kurth, Florian / Sander, Leif E / Witzenrath, Martin / Kuebler, Wolfgang M / Kwapiszewska, Grazyna / Preissner, Klaus T

Blood advances

2021 Volume 6, Issue 3, Page(s) 1074–1087

Abstract: ... its activation products in critically ill patients with COVID-19 in comparison with patients with severe acute ... in COVID-19 pathology. In this study, we determined the altered levels of factor XII (FXII) and ... influenza). Compatible with those data, we found rapid consumption of FXII in COVID-19 but not in ARDS ...

Abstract	The high incidence of thrombotic events suggests a possible role of the contact system pathway in COVID-19 pathology. In this study, we determined the altered levels of factor XII (FXII) and its activation products in critically ill patients with COVID-19 in comparison with patients with severe acute respiratory distress syndrome related to the influenza virus (acute respiratory distress syndrome [ARDS]-influenza). Compatible with those data, we found rapid consumption of FXII in COVID-19 but not in ARDS-influenza plasma. Interestingly, the lag phase in fibrin formation, triggered by the FXII activator kaolin, was not prolonged in COVID-19, as opposed to that in ARDS-influenza. Confocal and electron microscopy showed that increased FXII activation rate, in conjunction with elevated fibrinogen levels, triggered formation of fibrinolysis-resistant, compact clots with thin fibers and small pores in COVID-19. Accordingly, clot lysis was markedly impaired in COVID-19 as opposed to that in ARDS-influenza. Dysregulated fibrinolytic system, as evidenced by elevated levels of thrombin-activatable fibrinolysis inhibitor, tissue-plasminogen activator, and plasminogen activator inhibitor-1 in COVID-19 potentiated this effect. Analysis of lung tissue sections revealed widespread extra- and intravascular compact fibrin deposits in patients with COVID-19. A compact fibrin network structure and dysregulated fibrinolysis may collectively contribute to a high incidence of thrombotic events in COVID-19.
MeSH term(s)	COVID-19 ; Fibrin ; Fibrinolysis ; Humans ; SARS-CoV-2 ; Thrombosis/etiology
Chemical Substances	Fibrin (9001-31-4)
Language	English
Publishing date	2021-11-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2915908-8
ISSN	2473-9537 ; 2473-9529
ISSN (online)	2473-9537
ISSN	2473-9529
DOI	10.1182/bloodadvances.2021004816
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Article ; Online: How we approach thrombosis risk in children with COVID-19 infection and MIS-C.

Sharathkumar, Anjali A / Faustino, E Vincent S / Takemoto, Clifford M

Pediatric blood & cancer

2021 Volume 68, Issue 7, Page(s) e29049

Abstract: ... thrombosis risk and thromboprophylaxis in children with COVID-19. ... complication among critically ill individuals with coronavirus disease 2019 (COVID-19). While children are ... Significant knowledge deficits in understanding COVID-19-associated coagulopathy and thrombotic risk pose ...

Abstract	Thrombosis within the microvasculature and medium to large vessels is a serious and common complication among critically ill individuals with coronavirus disease 2019 (COVID-19). While children are markedly less likely to develop severe disease than adults, they remain at risk for thrombosis during acute infection and with the post-acute inflammatory illness termed multisystem inflammatory syndrome in children. Significant knowledge deficits in understanding COVID-19-associated coagulopathy and thrombotic risk pose clinical challenges for pediatric providers who must incorporate expert opinion and personal experience to manage individual patients. We discuss clinical scenarios to provide framework for characterizing thrombosis risk and thromboprophylaxis in children with COVID-19.
MeSH term(s)	Adolescent ; Anticoagulants/administration & dosage ; COVID-19/blood ; COVID-19/drug therapy ; Child ; Female ; Humans ; Male ; SARS-CoV-2/metabolism ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/drug therapy ; Thrombosis/blood ; Thrombosis/drug therapy
Chemical Substances	Anticoagulants
Language	English
Publishing date	2021-05-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.29049
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Article ; Online: COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic.

Parks, Anna L / Auerbach, Andrew D / Schnipper, Jeffrey L / Anstey, James E / Sterken, David G / Hecht, Todd E H / Fang, Margaret C

Thrombosis research

2020 Volume 196, Page(s) 355–358

Abstract: ... management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and ... prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D ... As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions ...

Abstract	As the Coronavirus disease 2019 (COVID-19) pandemic spread to the US, so too did descriptions of an associated coagulopathy and thrombotic complications. Hospitals created institutional protocols for inpatient management of COVID-19 coagulopathy and thrombosis in response to this developing data. We collected and analyzed protocols from 21 US academic medical centers developed between January and May 2020. We found greatest consensus on recommendations for heparin-based pharmacologic venous thromboembolism (VTE) prophylaxis in COVID-19 patients without contraindications. Protocols differed regarding incorporation of D-dimer tests, dosing of VTE prophylaxis, indications for post-discharge pharmacologic VTE prophylaxis, how to evaluate for VTE, and the use of empiric therapeutic anticoagulation. These findings support ongoing efforts to establish international, evidence-based guidelines.
MeSH term(s)	Academic Medical Centers ; Anticoagulants/administration & dosage ; Anticoagulants/adverse effects ; Blood Coagulation/drug effects ; COVID-19/blood ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/drug therapy ; Clinical Protocols ; Consensus ; Healthcare Disparities/trends ; Humans ; Practice Patterns, Physicians'/trends ; Pulmonary Embolism/blood ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/etiology ; Pulmonary Embolism/prevention & control ; Risk Assessment ; Risk Factors ; Thrombophilia/blood ; Thrombophilia/diagnosis ; Thrombophilia/etiology ; Thrombophilia/prevention & control ; Treatment Outcome ; United States ; Venous Thromboembolism/blood ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Venous Thrombosis/blood ; Venous Thrombosis/diagnosis ; Venous Thrombosis/etiology ; Venous Thrombosis/prevention & control
Chemical Substances	Anticoagulants
Keywords	covid19
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Letter
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2020.09.018
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Book ; Online: Problemas de coagulación y trombos en pacientes con COVID-19

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Article: [Association between cardio-ankle vascular index and markers of thrombosis in hospitalized patients COVID-19].

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Article ; Online: Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination.

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Article ; Online: Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C.

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Article ; Online: Altered fibrin clot structure and dysregulated fibrinolysis contribute to thrombosis risk in severe COVID-19.

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Article ; Online: How we approach thrombosis risk in children with COVID-19 infection and MIS-C.

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Article ; Online: COVID-19 coagulopathy and thrombosis: Analysis of hospital protocols in response to the rapidly evolving pandemic.

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