Corpus overview


MeSH Disease

Human Phenotype


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    Association of D-dimer and fibrinogen magnitude with hypercoagulability HP by thromboelastography in severe COVID-19

    Authors: Abhimanyu Chandel; Saloni Patolia; Mary Looby; Heidi Dalton; Najeebah Bade; Vikramjit Khangoora; Mehul Desai; James Lantry; Erik Osborn; Svetolik Djurkovic; Daniel Tang; Steven D Nathan; Christopher S King

    doi:10.1101/2020.07.27.20162842 Date: 2020-07-29 Source: medRxiv

    Introduction: D-dimer concentration has been used to identify candidates for intensified anticoagulant treatment for both venous thromboembolism MESHD thromboembolism HP prevention and mitigation of the microthrombotic complications associated with COVID-19. Thromboelastography (TEG) maximum amplitude (MA) has been validated as an indicator of hypercoagulability HP and MA [≥] 68 mm has been utilized as a marker of hypercoagulability HP in other conditions. We evaluated the relationship between coagulation, inflammatory, and TEG parameters in patients with COVID-19 on extracorporeal membrane oxygenation (ECMO). Methods: We performed a single center retrospective analysis of consecutive patients that received ECMO for the treatment of COVID-19. TEG, inflammatory, and coagulation markers were compared in patients with and without thrombotic complications. Correlation tests were performed to identify the coagulation and inflammatory markers that best predict hypercoagulability HP as defined by an elevated TEG MA. Results: 168 TEGs were available in 24 patients. C-reactive protein and fibrinogen were significantly higher in patients that developed a thrombotic event versus those that did not (p=0.038 and p=0.043 respectively). D-dimer was negatively correlated with TEG MA (p<0.001) while fibrinogen was positively correlated (p<0.001). A fibrinogen > 441 mg/dL had a sensitivity SERO of 91.2% and specificity of 85.7% for the detection of MA [≥] 68 mm. Conclusions: In critically ill patients with COVID-19, D-dimer concentration had an inverse relationship with hypercoagulability HP as measured by TEG MA. D-dimer elevation may reflect severity of COVID-19 related sepsis MESHD sepsis HP rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability HP in this population.

    COVID-19 induces a hyperactive phenotype in circulating platelets

    Authors: Shane P Comer; Sarah Cullivan; Paulina B Szklanna; Luisa Weiss; Steven Cullen; Sarah Kelliher; Albert Smolenski; Niamh Moran; Claire Murphy; Haidar Altaie; John Curran; Katherine O'Reilly; Aoife G Cotter; Brian Marsh; Sean Gaine; Patrick Mallon; Brian McCullagh; Fionnuala Ní Áinle; Barry Kevane; Patricia B Maguire

    doi:10.1101/2020.07.24.20156240 Date: 2020-07-26 Source: medRxiv

    Background Coronavirus disease MESHD 2019 (COVID-19), caused by novel coronavirus SARS-CoV-2, has to date affected over 13.3 million globally. Although high rates of venous thromboembolism MESHD thromboembolism HP and evidence of COVID-19-induced endothelial dysfunction have been reported, the precise aetiology of the increased thrombotic risk associated with COVID-19 infection MESHD remains to be fully elucidated. Objectives Here, we assessed clinical platelet parameters and circulating platelet activity in patients with severe and non-severe COVID-19. Methods An assessment of clinical blood SERO parameters in patients with severe COVID-19 disease MESHD (requiring intensive care), patients with non-severe disease MESHD (not requiring intensive care), general medical in-patients without COVID-19 and healthy donors was undertaken. Platelet function and activity were also assessed by secretion and specific marker analysis. Results We show that routine clinical blood SERO parameters including increased MPV and decreased platelet:neutrophil ratio are associated with disease MESHD severity in COVID-19 upon hospitalisation and intensive care unit admission. Strikingly, agonist-induced ADP release was dramatically higher in COVID-19 patients compared with non-COVID-19 hospitalized patients and circulating levels of PF4, sP-selectin and TPO were also significantly elevated in COVID-19. Conclusion Distinct differences exist in routine full blood SERO count and other clinical laboratory parameters between patients with severe and non-severe COVID-19. Moreover, we have determined that COVID-19 patients possess hyperactive circulating platelets. These data suggest that abnormal platelet reactivity may contribute to hypercoagulability HP in COVID-19. Further investigation of platelet function in COVID-19 may provide additional insights into the aetiology of thrombotic risk in this disease MESHD and may contribute to the optimisation of thrombosis MESHD prevention and treatment strategies.

    COVID-19 and Ischemic Stroke HP Stroke MESHD

    Authors: Amira Sidig; Khabab Abbasher; Hussien Abbasher; Radi Tofaha Alhusseini; Mohamed Elsayed; Mohammed Abbasher; Sufian Khalid M. N; Khalid Hajnoor; Mohammed Malekaldar; Mutaz F. Digna; Abbasher Hussien; Omer Eladil A. Hamid

    doi:10.21203/ Date: 2020-07-26 Source: ResearchSquare

    Background: SARS-CoV-2 causes COVID-19 disease MESHD. It was identified in December 2019 and rapidly evolved into a pandemic. During the outbreak of COVID-19, researches demonstrated its effect on many systems, including the nervous system. In our clinic, we have reported an impact of SARS-CoV-2, causing the ischaemic stroke MESHD stroke HP.Case Report: A 62-year-old Sudanese male TRANS with some comorbidities brought to the A&E with fever MESHD fever HP, chest symptoms, and acute evolving left-sided hemiplegia MESHD hemiplegia HP power grade 0/5 MRCS with left upper motor neuron facial palsy HP. Investigations: CT brain: right middle cerebral artery MCA infarction MESHD. CT- chest: bilateral ground-glass appearance. COVID-19 Test was positive. elevated D-dimer and C-reactive protein.Discussion: A retrospective study of data from the COVID-19 outbreak in China showed that the incidence of stroke MESHD stroke HP among hospitalized patients was approximately 5%. The fact that COVID-19 is an acute inflammatory condition associated with an increased incidence of fatty plaques formation, injury of the vascular wall, and hypercoagulability HP, causing brain infarct can be a reasonable hypothesis.ConclusionPatients with COVID-19 are at increased risk of thrombo-embolization, leading to arterial and venous cerebrovascular accident. This case report enhances the importance of further studies to clarify the relationship between stroke MESHD stroke HP and COVID-19.

    Is COVID-19 a Risk Factor of DVT in Orthopaedic Trauma Surgery? A Prospective Study

    Authors: Anıl Agar; Orhan Gunes; Adem Sahin; Bulent Kılıc; Sumeyra Dogan; Ali Kocatas; Cemil Erturk; Deniz Gulabi

    doi:10.21203/ Date: 2020-07-22 Source: ResearchSquare

    Objective: The aim of this prospective study was to evaluate the radiological and laboratory parameters of patients diagnosed with COVID-19 who underwent surgery for a lower extremity fracture in our COVID-19 care units in terms of DVT.Patients and Methods: Patients who were operated on due to lower extremity fracture between 10 March and 1 May and diagnosed with COVID-19 were evaluated prospectively. Patients’ age TRANS, gender TRANS, affected side, fracture location, fracture type, COVID-19  radiological or clinical symptoms and Doppler USG and biochemical markers screening for DVT were evaluated.Results: Thirty patients, ages TRANS 39-88, were included in the study. Preoperative D-dimer value of the patients was mean 5.9 mg / L. In all the patients, the D-dimer level was above the normal range. The mean troponin value was 0.025 ng / mL preoperatively. The troponin value was found to be normal in 8 patients and above the normal value in 22 patients. On physical examination, DVT findings were present in 1 patient and DVT was detected in 2 patients on doppler ultrasound.Conclusion: It can be recommended that extra attention should be given to vascular complications in COVID-19 positive trauma patients, as both the effect of trauma itself increases hypercoagulability HP and COVID-19 disease MESHD seems to have the potential to increase hypercoagulability HP.

    Asymptomatic TRANS COVID-19 Patient, Occurrence of Fatal Pulmonary Arterial Thrombosis HP Thrombosis MESHD.

    Authors: Franca Del Nonno; Daniele Colombo; Roberta Nardacci; Laura Falasca

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    The induction of hypercoagulability HP is one of the pathophysiological mechanism in patients with a severe presentation of the SARS-CoV-2 infection MESHD that can contribute to death MESHD. A considerable number of SARS-Cov-2 infected individuals could be asymptomatic TRANS and they don’t need medical treatment. We reported autoptic evidences of COVID-19 trombotic fatal lesions in a asymptomatic COVID-19 patient after negative conversion.This study provides evidences that an appropriate diagnostic screening for thrombotic complications and the early treatment recommendations of antithrombotic drugs could represent an important topic even in asymptomatic TRANS individuals. 

    Early initiation of Extracorporeal Blood SERO Purification using the AN69ST (oXiris®) hemofilter as a treatment modality for COVID - 19 patients: a single-centre case series

    Authors: Petar Ugurov; Dijana Popevski; Tanja Gramosli; Dashurie Neziri; Dragica Vuckova; Emil Stoicovski; Lidija Veljanovska-Kiridjievska; Katerina Ignevska; Sanja Mehandziska; Elena Ambarkova; Rodney Alexander Rosalia; Zan Mitrev

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Introduction: Our understanding of the COVID-19 disease MESHD has been steadily evolving since the original outbreak in December 2019. Advanced disease MESHD is characterised by a hyperinflammatory state, systemic coagulopathies and multiorgan involvement, in particular respiratory distress HP. We here describe our initial experience with treating of COVID-19 patients based on early initiation of extracorporeal blood SERO purification, systemic heparinisation and respiratory support.Methods: 15 patients were included; 2 were females TRANS. We monitored real-time several biochemical, immunological and coagulation biomarkers associated with disease MESHD severity following admission to our dedicated COVID-19 intensive care unit. To guide personalised treatment, we monitored among others levels of IL-6, IL-8, TNF-α, C-Reactive Protein (CRP), Neutrophil-to-Lymphocyte ratios, Thrombocyte counts, D-Dimers, Fibrinogen, and Activation Clotting time (ACT).Treatment consisted of individualised respiratory support supplemented with 1 - 4 cycles of 24-hour Extracorporeal Organ Support (ECOS) and Blood SERO Purification using the AN69ST (oXiris®) hemofilter. We administered heparin (300 U/kg) to counter suspected hypercoagulability HP (= elevated Fibrinogen or D-dimers) states to maintain ACT ≥ 180 seconds.Results: N = 10 presented with severe to critical disease MESHD (= dyspnoea, hypoxia MESHD, respiratory rate > 30/min, peripheral oxygen saturation < 90%, or > 50% lung involvement on X-ray imaging). A single case was admitted with a critical condition (= respiratory failure HP). One patient died after 5 days of hospitalisation after developing Acute Respiratory Syndrome MESHD. 8 Patients have been discharged - average ICU length-of-stay was 9.9 ± 2.4 days. Clinical improvement was associated with normalisation (increase) of thrombocytes, white blood SERO cells, stable levels of IL-6 (< 50 ng/mL) and a decrease of CRP and Fibrinogen. Conclusion: Means to monitor COVID-19 disease MESHD severity during hospitalisation are crucial to control disease progression MESHD and prevent hyperinflammation and irreversible multiorgan failure. We present here a real-time monitoring system accounting for biochemical, immunological, coagulation parameters and radiological imaging. The combination of systemic heparin anticoagulation regimens and blood SERO purification may prevent hyperinflammation, thromboembolism MESHD thromboembolism HP during hospitalisation and thus support clinical recovery. 

    Injury-Prone: Peripheral nerve injuries MESHD associated with prone positioning for COVID-19-related acute respiratory distress HP syndrome MESHD

    Authors: George R. Malik; Alexis R. Wolfe; Rachna Soriano; Leslie Rydberg; Lisa F. Wolfe; Swati Deshmukh; Jason H. Ko; Ryan P. Nussbaum; Prakash Jayabalan; James M. Walter; Colin K. Franz

    doi:10.1101/2020.07.01.20144436 Date: 2020-07-02 Source: medRxiv

    Patients with Coronavirus disease MESHD 2019 (COVID-19) who require invasive mechanical ventilation frequently meet the acute respiratory distress HP syndrome MESHD (ARDS) diagnostic criteria. Hospitals based in the United States have been incorporating prone positioning (PP) into the COVID-19-related ARDS treatment plan at a higher rate than normal. Here, we describe 11 patients admitted to a single inpatient rehabilitation hospital who were subsequently diagnosed with acquired focal/multifocal peripheral nerve injury MESHD (PNI) in association with the use of PP for COVID-19-related ARDS. The reason for the high rate of PNI associated with PP in COVID-19 ARDS is likely multifactorial, but may include an underlying state of hyperinflammation and hypercoagulability HP already linked to other the neurological sequelae of COVID-19. Physicians must be aware of this elevated susceptibility to PNI in severe COVID-19 and refined standard PP protocols in order to reduce the risk.

    Superior anticoagulation strategies for renal replacement therapy in critically ill patients with COVID-19: a cohort study

    Authors: Frederic Arnold; Lukas Westermann; Siegbert Rieg; Elke Neumann-Haefelin; Paul Biever; Gerd Walz; Johannes Kalbhenn; Yakup Tanriver

    doi:10.1101/2020.06.26.20140699 Date: 2020-07-01 Source: medRxiv

    Background Coronavirus disease MESHD 2019 (COVID-19) patients who are admitted to intensive care units (ICU) have a high risk of requiring renal replacement therapy (RRT) due to acute kidney injury MESHD acute kidney injury HP (AKI). Concomitantly, COVID-19 patients exhibit a state of hypercoagulability HP that can affect circuit lifespan. An optimal anticoagulation strategy is therefore needed in order to maintain circuit patency and therapeutic efficiency of RRT. Methods Retrospective single-centre cohort study on 71 critically ill COVID-19 patients at the University of Freiburg Medical Center. Included were all patients aged TRANS 18 years and older with confirmed severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD that were admitted to ICU between February 26 and May 21, 2020. We collected data on the COVID-19 disease MESHD course, AKI, RRT, thromboembolic events and anticoagulation. Primary outcome of the study was the effect of different anticoagulation strategies during RRT on extracorporeal circuit lifespans. Results Anticoagulation during continuous veno-venous haemodialysis (CVVHD) was performed with unfractionated heparin (UFH) or citrate. Mean treatment time in the UFH group was 21.3h (SEM: {+/-}5.6h). Mean treatment time in the citrate group was 45.6h (SEM: {+/-}2.7h). Citrate anticoagulation prolonged treatment duration significantly by 24.4h (p=0.0014). Anticoagulation during sustained low-efficiency daily dialysis (SLEDD) was performed with UFH, argatroban or low molecular weight heparin (LMWH). Mean dialysis time with UFH was 8.1h (SEM: {+/-}1.3h), argatroban 8.0h (SEM: {+/-}0.9h) and LMWH 11.8h (SEM: {+/-}0.5h). Compared to UFH and argatroban, LMWH significantly prolonged treatment times by 3.7h (p=0.0082) and 3.8h (p=0.0024), respectively. Conclusions UFH fails to prevent early clotting events in dialysis circuits. For patients, who do not require an effective systemic anticoagulation, regional citrate dialysis is the most effective strategy in our cohort. For patients, who require an effective systemic anticoagulation treatment, the usage of LMWH results in the longest circuit life spans.

    Case Report – Inferior Mesenteric Vein Thrombosis MESHD and COVID-19

    Authors: Aureo do Carmo Filho; Bruno da Silva Cunha

    id:10.20944/preprints202006.0282.v1 Date: 2020-06-21 Source:

    Since its inception in December 2019, Covid-19 has challenged the global scientific community. Some treatments were used in this infection MESHD, but doubts still persist regarding the use of medications 1. More severe cases complicate with endothelial dysfunction, excess thrombin synthesis and decreased fibrinolysis which, associated with hypoxemia HP, lead to a hypercoagulability HP state 2 and some authors indicate the use of anticoagulants for these 3. For mild cases, doubts remain regarding this indication. We will report the case of a patient with mild symptoms of covid-19, complicated by inferior mesenteric vein thrombosis MESHD.

    A Narrative Review on Evaluation of Hypercoagulability HP State in Severe COVID-19 Patients with Background Risk Factors

    Authors: Minoosh Moghimi; Kasra Khodadadi; Yousef Mortazavi

    id:10.20944/preprints202006.0062.v1 Date: 2020-06-07 Source:

    COVID-19 induces coagulopathy at the base of SIC ( sepsis MESHD sepsis HP-induced coagulopathy) and it is an important cause of death MESHD in the patients. Cytokine storm causes imbalance in coagulation and fibrinolytic system. A combination of hypercoagulability HP state, decrease or inhibition of fibrinolytic and endothelialopathy causes thromboembolic events. Underlined disease MESHD with a high rate of mortality in COVID-19 like diabetes, hypertension MESHD hypertension HP and some conditions like aging and obesity MESHD obesity HP are the main disorders with hemostatic MESHD disturbance and increase of coagulopathy. Therefore, it seems that the combination of COVID-19 infection MESHD infection and these risk TRANS infection and these risk TRANS and these risk factors increase the risk of thromboembolic all together.

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MeSH Disease
Human Phenotype

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