Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation

Frontiers in Medicine

article

Xu Qi¹  Wenjuan Wu²  Mingjie Wu³  Chaolin Huang³  Yu Li⁴  Yun Liu¹  Jinhai Tang¹  Hui Kong¹  Wenqiu Ding¹  Chaojie Wu¹  Ningfei Ji¹  Mao Huang¹  Tiantian Li¹  Xinyu Wang¹  Jingli Wen¹ 

[1] Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University;Division of Intensive Care Unit, Wuhan Jin Yin-tan Hospital;The Third Clinical Medical College, Nanjing University of Chinese Medicine;School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine

关键词: COVID-19;    metabolic disorder;    coagulation function;    hypocalcemia;    inflammation;   

DOI  :  10.3389/fmed.2021.638194

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

This study aimed to detect, analyze, and correlate the clinical characteristics, blood coagulation functions, blood calcium levels, and inflammatory factors in patients with mild and severe COVID-19 infections. The enrolled COVID-19 infected patients were from Wuhan Jin Yin-tan Hospital (17 cases, Wuhan, China), Suzhou Infectious Disease Hospital (87 cases, Suzhou, China), and Xuzhou Infectious Disease Hospital (14 cases, Xuzhou, China). After admission, basic information was collected; X-ray and chest CT images were obtained; and data from routine blood tests, liver and kidney function, myocardial enzymes, electrolytes, blood coagulation function, (erythrocyte sedimentation rate) ESR, C-reactive protein (CRP), IL-6, procalcitonin (PCT), calcitonin, and other laboratory tests were obtained. The patients were grouped according to the clinical classification method based on the pneumonia diagnosis and treatment plan for new coronavirus infection (trial version 7) in China. The measurements from mild (56 cases) and severe cases (51 cases) were compared and analyzed. Most COVID-19 patients presented with fever. Chest X-ray and CT images showed multiple patchy and ground glass opacities in the lungs of COVID 19 infected patients, especially in patients with severe cases. Compared with patients with mild infection, patients with severe infection were older ( p = 0.023) and had a significant increase in AST and BUN. The levels of CK, LDH, CK-MB, proBNP, and Myo in patients with severe COVID-19 infection were also increased significantly compared to those in patients with mild cases. Patients with severe COVID-19 infections presented coagulation dysfunction and increased D-dimer and fibrin degradation product (FDP) levels. Severe COVID-19 patients had low serum calcium ion (Ca 2+ ) concentrations and high calcitonin and PCT levels and exhibited serious systemic inflammation. Ca 2+ in COVID-19 patients was significantly negatively correlated with PCT, calcitonin, D-dimer, PFDP, ESR, CRP and IL-6. D-dimer in COVID-19 patients was a significantly positively correlated with CRP and IL-6. In conclusion, patients with severe COVID-19 infection presented significant metabolic dysfunction and abnormal blood coagulation, a sharp increase in inflammatory factors and calcitonin and procalcitonin levels, and a significant decrease in Ca 2+ . Decreased Ca 2+ and coagulation dysfunction in COVID-19 patients were significantly correlated with each other and with inflammatory factors.

【 授权许可】

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