Authors: Cristina Maria Mărginean1, Viorel Biciușcă2, Iulia Cristina Mărginean3, Alina-Elena Ciobanu3, Marian Sorin Popescu3, Paul Mitruț1, George Alexandru Iacob3, Daniela Ciobanu1
1 Department of Internal Medicine University of Medicine and Pharmacy of Craiova, Romania
2 Department of Pneumology, University of Medicine and Pharmacy of Craiova, Romania
3 University of Medicine and Pharmacy of Craiova, Romania
Background. Determining the risk factors associated with the severity and prognosis of SARS-CoV-2 infection is of crucial importance for a correct diagnosis and management. Severe forms are correlated with increased inflammatory response and procoagulant status, highlighted by increased markers of inflammation and serum level of D-dimers.
Aims. The study aims to evaluate the association between disease severity and the inflammatory syndrome and COVID-19 associated coagulopathy, as well as the existence of a concordance of these parameters in the studied patients.
Methods. We performed a retrospective study, enrolling 99 patients with COVID-19 severe forms admitted to the intensive care unit of Craiova County Emergency Hospital, between 1 January and 1 September 2021. We measured biological markers of inflammation, markers of coagulopathy, serum albumin, LDH.
Results. The patients were divided into two groups: G1–51 patients with severe infection that have deceased, and G2–48 patients with severe infection who survived. All biological markers associated with inflammation showed increased values: leukocyte count, neutrophil-to- lymphocyte ratio, serum fibrinogen andLDH. Significantly increased levels of D-dimers were observed in most of all patients included and a significant association of these parameters with the disease severity. Our best linear regression model correlatedthe COVID-19 associated coagulopathy and the systemic inflammation.
Conclusions. Our study revealed a significant association between markers of the inflammatory response and procoagulant status highlighted by increased D-dimers. Most patients with severe forms of infection had coagulation abnormalities, correlated with the presence of systemic inflammation.
Key words: SARS-CoV-2 infection, inflammation, coagulopathy.