Elevated TAT in COVID-19 Patients with Normal D-Dimer as a Predictor of Severe Respiratory Failure: A Retrospective Analysis of 797 Patients
Although previous studies have revealed that elevated D-dimer in the early stage of coronavirus 2019 (COVID-19) indicates pulmonary intravascular coagulation, the state of coagulation/fibrinolysis disorder with normal D-dimer is unknown. The study aimed to investigate how coagulation/fibrinolysis ma...
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| Veröffentlicht in: | Journal of clinical medicine 2021-12, Vol.11 (1), p.134 |
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| creator | Takeshita, Yuichiro Terada, Jiro Hirasawa, Yasutaka Kinoshita, Taku Tajima, Hiroshi Koshikawa, Ken Kinouchi, Toru Isaka, Yuri Shionoya, Yu Fujikawa, Atsushi Tada, Yuji Nakaseko, Chiaki Tsushima, Kenji |
| description | Although previous studies have revealed that elevated D-dimer in the early stage of coronavirus 2019 (COVID-19) indicates pulmonary intravascular coagulation, the state of coagulation/fibrinolysis disorder with normal D-dimer is unknown. The study aimed to investigate how coagulation/fibrinolysis markers affect severe respiratory failure in the early stage of COVID-19. Among 1043 patients with COVID-19, 797 patients were included in our single-center retrospective study. These 797 patients were divided into two groups, the normal D-dimer and elevated D-dimer groups and analyzed for each group. A logistic regression model was fitted for age, sex, body mass index (BMI) ≥ 30 kg/m
, fibrinogen ≥ 617 mg/dL, thrombin-antithrombin complex (TAT) ≥ 4.0 ng/mL, and plasmin-alpha2-plasmin inhibitor-complex (PIC) > 0.8 µg/mL. A multivariate analysis of the normal D-dimer group demonstrated that being male and TAT ≥ 4.0 ng/mL significantly affected severe respiratory failure. In a multivariate analysis of the elevated D-dimer group, BMI ≥ 30 kg/m
and fibrinogen ≥ 617 mg/dL significantly affected severe respiratory failure. The elevated PIC did not affect severe respiratory failure in any group. Our study demonstrated that hypercoagulation due to SARS-CoV-2 infection may occur even during a normal D-dimer level, causing severe respiratory failure in COVID-19. |
| doi_str_mv | 10.3390/jcm11010134 |
| format | Article |
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, fibrinogen ≥ 617 mg/dL, thrombin-antithrombin complex (TAT) ≥ 4.0 ng/mL, and plasmin-alpha2-plasmin inhibitor-complex (PIC) > 0.8 µg/mL. A multivariate analysis of the normal D-dimer group demonstrated that being male and TAT ≥ 4.0 ng/mL significantly affected severe respiratory failure. In a multivariate analysis of the elevated D-dimer group, BMI ≥ 30 kg/m
and fibrinogen ≥ 617 mg/dL significantly affected severe respiratory failure. The elevated PIC did not affect severe respiratory failure in any group. Our study demonstrated that hypercoagulation due to SARS-CoV-2 infection may occur even during a normal D-dimer level, causing severe respiratory failure in COVID-19.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm11010134</identifier><identifier>PMID: 35011875</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Body mass index ; Clinical medicine ; Coronaviruses ; COVID-19 ; Ethics ; Laboratories ; Patients ; Pneumonia ; Respiratory failure ; Sea level ; Variables</subject><ispartof>Journal of clinical medicine, 2021-12, Vol.11 (1), p.134</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-71b413585091b6f48bfb6407906c92773d20b0ee5dc054c943f28dae7dfa66a33</citedby><cites>FETCH-LOGICAL-c409t-71b413585091b6f48bfb6407906c92773d20b0ee5dc054c943f28dae7dfa66a33</cites><orcidid>0000-0001-6706-5595 ; 0000-0001-7829-8968 ; 0000-0003-1175-226X ; 0000-0002-8299-4250 ; 0000-0001-5718-5120</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745035/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745035/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35011875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeshita, Yuichiro</creatorcontrib><creatorcontrib>Terada, Jiro</creatorcontrib><creatorcontrib>Hirasawa, Yasutaka</creatorcontrib><creatorcontrib>Kinoshita, Taku</creatorcontrib><creatorcontrib>Tajima, Hiroshi</creatorcontrib><creatorcontrib>Koshikawa, Ken</creatorcontrib><creatorcontrib>Kinouchi, Toru</creatorcontrib><creatorcontrib>Isaka, Yuri</creatorcontrib><creatorcontrib>Shionoya, Yu</creatorcontrib><creatorcontrib>Fujikawa, Atsushi</creatorcontrib><creatorcontrib>Tada, Yuji</creatorcontrib><creatorcontrib>Nakaseko, Chiaki</creatorcontrib><creatorcontrib>Tsushima, Kenji</creatorcontrib><title>Elevated TAT in COVID-19 Patients with Normal D-Dimer as a Predictor of Severe Respiratory Failure: A Retrospective Analysis of 797 Patients</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Although previous studies have revealed that elevated D-dimer in the early stage of coronavirus 2019 (COVID-19) indicates pulmonary intravascular coagulation, the state of coagulation/fibrinolysis disorder with normal D-dimer is unknown. The study aimed to investigate how coagulation/fibrinolysis markers affect severe respiratory failure in the early stage of COVID-19. Among 1043 patients with COVID-19, 797 patients were included in our single-center retrospective study. These 797 patients were divided into two groups, the normal D-dimer and elevated D-dimer groups and analyzed for each group. A logistic regression model was fitted for age, sex, body mass index (BMI) ≥ 30 kg/m
, fibrinogen ≥ 617 mg/dL, thrombin-antithrombin complex (TAT) ≥ 4.0 ng/mL, and plasmin-alpha2-plasmin inhibitor-complex (PIC) > 0.8 µg/mL. A multivariate analysis of the normal D-dimer group demonstrated that being male and TAT ≥ 4.0 ng/mL significantly affected severe respiratory failure. In a multivariate analysis of the elevated D-dimer group, BMI ≥ 30 kg/m
and fibrinogen ≥ 617 mg/dL significantly affected severe respiratory failure. The elevated PIC did not affect severe respiratory failure in any group. 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The study aimed to investigate how coagulation/fibrinolysis markers affect severe respiratory failure in the early stage of COVID-19. Among 1043 patients with COVID-19, 797 patients were included in our single-center retrospective study. These 797 patients were divided into two groups, the normal D-dimer and elevated D-dimer groups and analyzed for each group. A logistic regression model was fitted for age, sex, body mass index (BMI) ≥ 30 kg/m
, fibrinogen ≥ 617 mg/dL, thrombin-antithrombin complex (TAT) ≥ 4.0 ng/mL, and plasmin-alpha2-plasmin inhibitor-complex (PIC) > 0.8 µg/mL. A multivariate analysis of the normal D-dimer group demonstrated that being male and TAT ≥ 4.0 ng/mL significantly affected severe respiratory failure. In a multivariate analysis of the elevated D-dimer group, BMI ≥ 30 kg/m
and fibrinogen ≥ 617 mg/dL significantly affected severe respiratory failure. The elevated PIC did not affect severe respiratory failure in any group. Our study demonstrated that hypercoagulation due to SARS-CoV-2 infection may occur even during a normal D-dimer level, causing severe respiratory failure in COVID-19.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>35011875</pmid><doi>10.3390/jcm11010134</doi><orcidid>https://orcid.org/0000-0001-6706-5595</orcidid><orcidid>https://orcid.org/0000-0001-7829-8968</orcidid><orcidid>https://orcid.org/0000-0003-1175-226X</orcidid><orcidid>https://orcid.org/0000-0002-8299-4250</orcidid><orcidid>https://orcid.org/0000-0001-5718-5120</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Body mass index Clinical medicine Coronaviruses COVID-19 Ethics Laboratories Patients Pneumonia Respiratory failure Sea level Variables |
| title | Elevated TAT in COVID-19 Patients with Normal D-Dimer as a Predictor of Severe Respiratory Failure: A Retrospective Analysis of 797 Patients |
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