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Review paper
Received: 07.02.2023. >> Accepted: 31.03.2023. >> Published: 01.12.2022. Biochemistry
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https://doi.org/10.17392/1592-23

COVID-19 associated coagulopathy in septic critically ill patients - a retrospective cohort study

By
Mirza Kovačević Orcid logo ,
Mirza Kovačević
Contact Mirza Kovačević

Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

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Nermina Rizvanović ,
Nermina Rizvanović

Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

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Adisa Šabanović Adilović ,
Adisa Šabanović Adilović

School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

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Senada Čaušević
Senada Čaušević

Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

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Abstract

Aim
To determine the relationship between coagulation disorders and septic condition in COVID-19 critically ill patients.
Methods
Data from 99 patients who presented with COVID-19 acute hypoxemic respiratory failure (CAHRF) were divided into
two groups: Group 1- patients who developed sepsis, and Group 2 - patients who developed septic shock. Age, sex, comorbidities, quick Sequential Organ Failure Assessment (qSOFA) score, vasopressor and inotrope requirement, laboratory findings (platelets, neutrophils, lymphocytes, procalcitonin - PCT, C-reactive protein, fibrinogen, D-dimer, sepsis-induced coagulopathy – SIC, and disseminated intravascular coagulation - DIC score) were recorded on the day of admission and on the day of starting invasive mechanical ventilation. The primary outcome was to establish
COVID-19 associated coagulopathy with sepsis and septic shock; the secondary outcome measure was incidence of coagulopathy in septic COVID-19 critically ill patients.
Results
The most common coagulation abnormality was international normalized ratio (INR) (p=0.019) for Group 2, followed
by the values of inflammatory parameters PCT (p=0.002) and lymphocytes (p=0.011) also for Group 2. The statistical significance of SIC score was observed for both groups (p=0.007) and p=0.012, respectively. Norepinephrine (p=0.000) and dobutamine (p=0.000) for Group 2, qSOFA for both groups (p = 0.000) were
statistically significant.
Conclusion
The observed coagulation abnormalities met the criteria for a SIC diagnosis, therefore, the management of coagulation
disorders at this stage of the disease should follow the management of a septic condition.

Keywords:

coagulation disorders,
incidence,
sepsis

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