Analisis Faktor Koagulasi : Korelasi Fibrinogen dengan Rendahnya Derajat Oksigenasi Pada Pasien COVID-19

Coagulation Parameters in COVID-19

Authors

  • Aditya Sri Listyoko SMF Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya/ RS Dr Saiful Anwar, Indonesia
  • Susanthy Djajalaksana SMF Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya/ RS Dr Saiful Anwar, Indonesia
  • Yani Jane Sugiri SMF Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya/ RS Dr Saiful Anwar, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v8i2.549

Keywords:

Coagulation, COVID-19, D-Dimer, Fibrinogen

Abstract

Background: Hipercoagulable state is a one complication of COVID-19. The exact mechanism are still unclear, however hyperfibrinogenemia is considered one of the mechanisms for COVID-19 coagulopathy. Objective : To analyze the parameters of coagulation factors of COVID-19 patients and its correlation with degree of oxygenation Methods: We conducted an observational analytic, cross sectional, single-center study  including  25 laboratory-confirmed patients in Dr. Saiful Anwar General Hospital, Malang, Indonesia from April-Juni 2020. Statistical analysis performed to determine coagulation factors like fibrinogen, D-dimer, thrombocyte  and its relationship to disease severity and correlation with degree of oxygenation measured by PaO2/FiO2. Result: Subjects consisted of 12 patients (48%) in the mild-moderate group and 13 patients (52%) in severe group. D-dimer with mean 1,30 mg/L (0,43 mg/L - 4,08 mg/L) increased in 11 patients (91,67%) in mild-moderate group and 11 patients (84,61%) in severe group with mean 11,42 mg/L (0,34 mg/L – 66,30 mg/L). Fibrinogen with mean 399,73 mg/dL  (235,10 mg/dL -529 mg/dL) increased in 7 patients (58,33%) in mild-moderate and 10 patients (76,92%) in severe group with mean 444,31 mg/dL (284,7 mg/dL – 543,0 mg/dL). Statistical analysis revelaed that D-dimer associated with disease severity (p=0,039) and fibrinogen was inversely correlated with degree of oxygenation measured by PaO2/FiO2 ratio with moderate correlation strength (p = 0.019; Pearson correlation = -4,67). Conclusion: High level of fibrinogen correlated with decrease of oxygenation and D-dimer associated with disease severity in hospitalized patients, suggested increasing coagulable factors such as fibrinogen and D-dimer may be the main keys developing severe condition in COVID-19 patients.

Downloads

Download data is not yet available.

References

World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report-1 21 Januari 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4. Dipublikasikan 21 Januari 2020. Diakses 12 Maret 2020 jam 20.00.

Kemenkes RI. Infeksi Emerging : Media Informasi Resmi Terkini Penyakit Infeksi Emerging. https://infeksiemerging.kemkes.go.id/. Dipublikasikan 12 September 2020. Diakses 12 September 2020 jam 20.00.

Pemerintah Provinsi Jawa Timur. Jatim Tanggap Covid-19. http://infocovid19.jatimprov.go.id/. Dipublikasikan 12 September 2020. Diakses 12 September jam 20.00.

Pemerintah Kota Malang. Peta Persebaran Covid-19 di Kota Malang per 11 September 2020. https://malangkota.go.id/2020/09/11/peta-persebaran-covid-19-di-kota-malang-per-11-september-2020/. Dipublikasikan 12 September 2020. Diakses 12 September 2020 jam 20.00.

Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, Bolling MC, Dijkstra G, Voors AA, Osterhaus AD, van der Voort PH. Angiotensin?converting enzyme?2 (ACE2), SARS?CoV?2 and pathophysiology of coronavirus disease 2019 (COVID?19). The Journal of Pathology. 2020 May 17.

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. Jama. 2020 Jul 10.

Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID?19. Journal of Thrombosis and Haemostasis. 2020 Apr 17.

Barrett CD, Moore HB, Yaffe MB, Moore EE. ISTH interim guidance on recognition and management of coagulopathy in COVID?19: A Comment. Journal of Thrombosis and Haemostasis. 2020 Apr 17.

Kementrian Kesehatan Republik Indonesia. Pedoman Kesiapsiagaan Menghadapi COVID-19 Revisi 4, 27 Maret 2020. Jakarta: Kementerian Kesehatan Republik Indonesia. 2020; 45-47

Iba T, Levy JH, Thachil J, Wada H, Levi M. The progression from coagulopathy to disseminated intravascular coagulation in representative underlying diseases. Thrombosis research. 2019 Jul 1;179:11-4.

F.B. Taylor, C.H. Toh, W.K. Hoots, H. Wada, M. Levi, Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation, Thromb. Haemost. 86 (2001) 1327–1330.

Ranucci M, Ballotta A, Di Dedda U, Bayshnikova E, Dei Poli M, Resta M, Falco M, Albano G, Menicanti L. The procoagulant pattern of patients with COVID?19 acute respiratory distress syndrome. Journal of Thrombosis and Haemostasis. 2020 Apr 17.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine. 2020 Apr 30;382(18):1708-20.

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis. 2020 Apr;18(4):844-7.

Spiezia L, Boscolo A, Poletto F, Cerruti L, Tiberio I, Campello E, Navalesi P, Simioni P. COVID-19-related severe hypercoagulability in patients admitted to intensive care unit for acute respiratory failure. Thrombosis and haemostasis. 2020 Jun;120(6):998.

Additional Files

Published

2021-07-15

How to Cite

1.
Listyoko AS, Djajalaksana S, Sugiri YJ. Analisis Faktor Koagulasi : Korelasi Fibrinogen dengan Rendahnya Derajat Oksigenasi Pada Pasien COVID-19: Coagulation Parameters in COVID-19. Medica Hospitalia J. Clin. Med. [Internet]. 2021 Jul. 15 [cited 2024 Mar. 29];8(2):172-8. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/549

Issue

Section

Original Article

Citation Check