Systematic review of the prognostic utility of D-dimer, disseminated intravascular coagulation, and anticoagulant therapy in COVID-19 critically ill patients

G Moreno, R Carbonell, M Bodí, A Rodríguez, G Moreno, R Carbonell, M Bodí, A Rodríguez

Abstract

During the new pandemic caused by SARS-CoV-2, there is short knowledge regarding the management of different disease areas, such as coagulopathy and interpretation of D-dimer levels, its association with disseminated intravascular coagulation (DIC) and controversy about the benefit of anticoagulation. Thus, a systematic review has been performed to define the role of D-dimer in the disease, the prevalence of DIC and the usefulness of anticoagulant treatment in these patients. A literature search was performed to analyze the studies of COVID-19 patients. Four recommendations were drawn based on expert opinion and scientific knowledge, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The present review suggests the presence of higher levels of D-dimer in those with worse prognosis, there may be an overdiagnosis of DIC in the course of the disease and there is no evidence on the benefit of starting anticoagulant treatment based only on isolated laboratory data.

Keywords: Anticoagulación; Anticoagulation; COVID-19; Coagulación intravascular diseminada; D-dimer; Disseminated intravascular coagulation; Dímero D.

Copyright © 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Figures

Figura 1
Figura 1
Diagrama de la búsqueda bibliográfica.

References

    1. World Health Organization . World Health Organization; Ginebra: 2020. Coronavirus disease (COVID-19) outbreak. [consultado 18 Abr 2020]. Disponible en: .
    1. Culp W.C. Vol. 14. World Health Organization; Ginebra: 2020. p. e01218. (Coronavirus disease 2019 (COVID-19) situation repor-91). [consultado 18 Abr 2020]. Disponible en: = fcf0670b_4. A A Pract. 2020.
    1. Bhimraj A., Morgan R.L., Shumaker A.H., Lavergne V., Baden L., Cheng V.C. Infectious Diseases Society of America; Estaods Unidos: 2020. Infectious Diseases Society of America Guidelines on the treatment and management of patients with COVID-19.
    1. Tang N., Li D., Wang X., Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18:844–847. .
    1. Spiezia L., Boscolo A., Poletto F., Cerruti L., Tiberio I., Campello E. COVID-19-related severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure. Thromb Haemost. 2020:4–6. .
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan China: A retrospective cohort study. Lancet. 2020;395:1054–1062. .
    1. Klok F.A., Kruip M.J.H.A., van der Meer N.J.M., Arbous M.S., Gommers DAMPJ, Kant K.M. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020 .
    1. Lin L., Lu L., Cao W., Li T. Hypothesis for potential pathogenesis of SARS-CoV-2 infection–a review of immune changes in patients with viral pneumonia. Emerg Microbes Infect. 2020;9:727–732. .
    1. Sanabria A.J., Rigau D., Rotaeche R., Selva A., Marzo-Castillejo M., Alonso-Coello P. Sistema GRADE: Metodología para la realización de recomendaciones para la práctica clínica. Aten Primaria. 2015;47:48–55. .
    1. Richardson S., Hirsch J.S., Narasimhan M., Crawford J.M., McGinn T., Davidson K.W. Presenting characteristics comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;10022:1–8. .
    1. Terpos E., Ntanasis-Stathopoulos I., Elalamy I., Kastritis E., Sergentanis T.N., Politou M. Hematological findings and complications of COVID-19. Am J Hematol. 2020 .
    1. Giannis D., Ziogas I.A., Gianni P. Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1 MERS-CoV and lessons from the past. J Clin Virol. 2020;127:104362. .
    1. Evans C.E., Zhao Y.Y. Impact of thrombosis on pulmonary endothelial injury and repair following sepsis. Am J Physiol Lung Cell Mol Physiol. 2017;312:L441–L451. .
    1. Semeraro F., Ammollo C.T., Caironi P., Masson S., Latini R., Panigada M. Low D-dimer levels in sepsis: Good or bad? Thromb Res. 2019;174:13–15. .
    1. Ferrer R., Navas A., Adda M., Artigas A. Papel de la coagulación en la fisiopatología de la lesión pulmonar aguda. Paralelismo con la sepsis. Med Intensiva. 2008;32:304–311. .
    1. Semeraro N., Ammollo C.T., Semeraro F., Colucci M. Sepsis, thrombosis and organ dysfunction. Thromb Res. 2012;129:290–295. .
    1. Levi M., van der Poll T. Coagulation and sepsis. Thromb Res. 2017;149:38–44. .
    1. Milbrandt E.B., Reade M.C., Lee M., Shook S.L., Angus D.C., Kong L. Prevalence and significance of coagulation abnormalities in community-acquired pneumonia. Mol Med. 2009;15:438–445. .
    1. Bernard G.R., Vincent J.L., Laterre P.F., LaRosa S.P., Dhainaut J.F., Lopez-Rodríguez Á. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2011;345:219–225. .
    1. Schwameis M., Steiner M.M., Schoergenhofer C., Lagler H., Buchtele N., Jilma-Stohlawetz P. D-dimer and histamine in early stage bacteremia: A prospective controlled cohort study. Eur J Intern Med. 2015;26:782–786. .
    1. Zheng Y., Xu H., Yang M., Zeng Y., Chen H., Liu R. Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu. J Clin Virol. 2020;127:104366. .
    1. Han H., Yang L., Liu R., Liu F., Wu K.L., Li J. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med. 2020 .
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. .
    1. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan China. JAMA - J Am Med Assoc. 2020;323:1061–1069. .
    1. Zhang G., Hu C., Luo L., Fang F., Chen Y., Li J. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol. 2020;127:104364. .
    1. Chen T., Wu D., Chen H., Yan W., Yang D., Chen G. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ. 2020:368. .
    1. Lodigiani C., Iapichino G., Carenzo L., Cecconi M., Ferrazzi P., Sebastian T. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. .
    1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020:1–13. .
    1. Zhang G., Zhang J., Wang B., Zhu X., Wang Q., Qiu S. Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A retrospective analysis. Respir Res. 2020;21:1–10. .
    1. Gao Y., Li T., Han M., Li X., Wu D., Xu Y. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020:0–1. .
    1. Li X., Xu S., Yu M., Wang K., Tao Y., Zhou Y. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 .
    1. Wu C., Chen X., Cai Y., Xia J., Zhou X., Xu S. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020:1–10. .
    1. Zhang L., Yan X., Fan Q., Liu H., Liu X., Liu Z. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020:0–3. . 14859.
    1. Chen R., Liang W., Jiang M., Guan W., Zhan C., Wang T. Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China. Chest. 2020 .
    1. Wang L., He W., Yu X., Hu D., Bao M., Liu H. Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;11:20. .
    1. Qingchun Y., Peng W., Xingguang W., Guoqiang Q., Mei M., Xiwen T. Retrospective study of risk factors for severe SARS-Cov-2 infections in hospitalized adult patients. Polish Arch Intern Med. 2020 .
    1. Wada H., Gabazza E.C., Asakura H., Koike K., Okamoto K., Maruyama I. Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): Diagnostic criteria of the International Society of Thrombosis and Hemostasis (ISTH) and of the Japanese ministry of health and welfare for overt DIC. Am J Hematol. 2003;74:17–22. .
    1. Singh B., Hanson A.C., Alhurani R., Wang S., Herasevich V., Cartin-Ceba R. Trends in the incidence and outcomes of disseminated intravascular coagulation in critically Ill patients (2004-2010): A population-based study. Chest. 2013;143:1235–1242. .
    1. Deng Y., Liu W., Liu K., Fang Y.Y., Shang J., Zhou L. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan China: A retrospective study. Chin Med J (Engl). 2020:2019. .
    1. Lippi G., Plebani M., Henry B.M. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020;506:145–148. .
    1. American Society of Hematology. COVID-19 and coagulopathy: Frequently asked questions. Estados Unidos: American Society of Hematology; 2020 [consultado 20 Abr 2020]. Disponible en: .
    1. Wada H., Thachil J., Di Nisio M., Mathew P., Kurosawa S., Gando S. Guidance for diagnosis and treatment of disseminated intravascular coagulation from harmonization of the recommendations from three guidelines. J Thromb Haemost. 2013;11:761–767. . 5 1215.
    1. Dolhnikoff M., Duarte-Neto A.N., de Almeida Monteiro R.A., Ferraz da Silva L.F., Pierre de Oliveira E., Nascimento Saldiva P.H. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020. . 41484.
    1. Magro C., Mulvey J.J., Berlin D., Nuovo G., Salvatore S., Harp J. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases. Transl Res. 2020:1–13. . 04.007 2020.
    1. Jing-Chun S., Gang W., Wei Z., Yang Z., Wei-Qin L., Zhou Z. People's Liberation Army Professional Committee of Critical Care Medicine CS on T and H Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19. Mil Med Res. 2020;7:19. 0024.
    1. Sanz M., Hernández-Tejedor A., García ÁE, Rivera J.J., de Molina Ortiz F.J., Camps A.S. Recomendaciones de «hacer» y «no hacer» en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias (SEMICYUC) Med Intensiva. 2020 doi: 10.1016/j.medin.2020.04.001.
    1. Vivas D., Roldán V., Esteve-Pastor M.A., Roldán I., Tello-Montoliu A., Ruiz-Nodar J.M. Recomendaciones sobre el tratamiento antitrombótico durante la pandemia COVID-19. Posicionamiento del Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología. Rev Española Cardiol. 2020 . 04.006’.
    1. Tang N., Bai H., Chen X., Gong J., Li D., Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020 .
    1. Iba T., Levy J.H., Warkentin T.E., Thachil J., van der Poll T., Levi M. Diagnosis and management of sepsis-induced coagulopathy and disseminated intravascular coagulation. J Thromb Haemost. 2019;17:1989–1994. 1457.
    1. Bikdeli B., Madhavan M.V., Jimenez D., Chuich T., Dreyfus I., Driggin E. COVID-19 and thrombotic or thromboembolic disease: Implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol. 2020 .
    1. Witt D.M., Nieuwlaat R., Clark N.P., Ansell J., Holbrook A., Skov J. American Society of Hematology 2018 guidelines for management of venous thromboembolism: Optimal management of anticoagulation therapy. Blood Adv. 2018;2:3257–3291. .
    1. Rice T.W., Janz D.R. In defense of evidence-based medicine for the treatment of COVID-19 ARDS. Ann Am Thorac Soc. 2020 0:AnnalsATS. 202004-325IP. . 202004-325IP.
    1. SETH. Recomendaciones de tromboprofilaxis y tratamiento antitrombótico en pacientes. Sociedad Española de Trombosis y Hemostasia. Madrid: Sociedad Española de Trombosis y Hemostasia; 2020 [consultado 22 Abr 2020]. Disponible en: .
    1. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Ginebra: WHO. 2020;2019:12 [consultado 11 Abr 2020]. Disponible en: .
    1. Kahn S.R., Lim W., Dunn A.S., Cushman M., Dentali F., Akl E.A. Prevention of VTE in nonsurgical patients. Antithrombotic therapy and prevention of thrombosis, 9 th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141:e195S–e226S. .
    1. Thachil J., Tang N., Gando S., Falanga A., Cattaneo M., Levi M. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020:1–4. .
    1. Zhai Z., Li C., Chen Y., Gerotziafas G., Zhang Z., Wan J. Prevention and treatment of venous thromboembolism associated with coronavirus disease 2019 infection: A consensus statement before guidelines. Thromb Haemost. 2020 .
    1. Kalpatthi R., Kiss J.E. Thrombotic thrombocytopenic purpura heparin-induced thrombocytopenia, and disseminated intravascular coagulation. Crit Care Clin. 2020;36:77–357. .

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅