Can Routine Blood Tests Be Used To Predict The Prognosis of COVID-19 Patients Using Antithrombotic Drugs

Year 2022, Volume: 4 Issue: 2, 52 - 57, 31.08.2022

Bahadir Taslidere Ertan Sonmez Ayse Karatas Begüm Sakın Rümeyza Kazancıoğlu

https://doi.org/10.55994/ejcc.1150685

Abstract

Background: COVID-19 may predispose to thromboembolism due to excessive inflammation, hypoxia, and immobilization. We investigated whether these antithrombotic drugs are useful or harmful to tackle COVID-19 and which laboratory parameters are more usable for this purpose.
Materials and methods: In our study, patients diagnosed with COVID-19 while using antithrombotic drugs and COVID-19 patients who did not use antithrombotic drugs were compared. Demographic data, laboratory values, clinical results, duration of hospital stay, and mortality were noted and compared.
Results: The study was conducted on 236 patients admitted to the emergency department. The mean value of creatine, LDH, PT, NLR, troponin, and ferritin were higher in the drug-using group. Home quarantine and hospitalization rate was 68.8% (n = 33) in antiplatelet users, and 46.2% (n = 6) in the anticoagulant group.
Conclusion: The difference between the groups may have been caused by the number of chronic diseases and polypharmacy. The interaction of drugs used for the treatment of COVID-19 with antithrombotic agents is unknown. In addition, as the correlation between COVID-19 and thrombosis is not exactly known, adding antithrombotic drugs to the treatment of the disease is controversial. In our study, the biomarkers used to predict prognosis were worse in COVID-19 patients who continued antithrombotic therapy at the therapeutic dose. In the case of antithrombotic agents, the risks that may arise should always be considered. We recommend monitoring routine blood parameters, especially NLR, LDH, PT, APTT, troponin, and ferritin levels, for the prognosis monitoring of COVID-19 patients who will continue their current antithrombotic therapy

Keywords

COVİD-19, Antithrombotic, Prognosis, Biomarkers

References

• 1. Raskob GE, Angchaisuksiri P, Blanco AN, et al. Thrombosis: a major contributor to global disease burden. Arterioscler Thromb Vasc Biol. 2014; 34(11): 2363-71. doi: 10.1161/ATVBAHA.114.304488.
• 2. Goeijenbier M, van Wissen M, van de Weg C, et al. Review: viral infections and mechanisms of thrombosis and bleeding. J Med Virol. 2012; 84(10): 1680-96. doi: 10.1002/jmv.23354.
• 3. Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020; 191: 9-14. doi: 10.1016/j.thromres.2020.04.024
• 4. Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID 19. Thromb Res. 2020; 191: 145-7. doi: 10.1016/j.thromres.2020
• 5. Lim W, Meade M, Lauzier F, et al. Failure of anticoagulant thromboprophylaxis: risk factors in medical-surgical critically ill patients. Crit Care Med. 2015; 43(2): 401-10. doi: 10.1097/CCM.0000000000000713
• 6. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020; 18(5): 1023-6. doi: 10.1111/jth.14810
• 7. Iba T, Nisio MD, Levy JH, et al. New criteria for sepsis-induced coagulopathy (SIC) following the revised sepsis definition: a retrospective analysis of a nationwide survey. BMJ Open. 2017; 27; 7(9): 017046. doi:10.1136/bmjopen-2017-017046
• 8. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 28; 395(10229): 1054-62. doi:10.1016/S0140-6736(20)30566-3
• 9. Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. Comparative Study. J Thromb Haemost. 2020; 18(8): 1995-2002. doi: 10.1111/jth.14888.
• 10. Murray MK, Bode K, Whittaker P. Gender-specifc associations between coronary heart disease and other chronic diseases: crosssectional evaluation of national survey data from adult residents of Germany. J Geriatr Cardiol. 2019; 16(9): 663–70. doi: 10.11909/j.issn.1671-5411.2019.09.004.
• 11. Flaczyk A, Rosovsky RP, Reed CT, et al. Comparison of published guidelines for management of coagulopathy and thrombosis in critically ill patients with COVID 19: implications for clinical practice and future investigations. Crit Care. 2020; 16; 24(1): 559. doi: 10.1186/s13054-020-03273-y
• 12. Paranjpe I, Fuster V, Lala A, et al. Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19. J Am Coll Cardiol. 2020; 7; 76(1): 122-4. doi: 10.1016/j.jacc.2020.05.001.
• 13. Siegal DM, Barnes GD, Langlois NJ, et al. A toolkit for the collection of thrombosis-related data elements in COVID-19 clinical studies. Blood Adv. 2020; 22; 4(24): 6259-73. doi: 10.1182/bloodadvances.2020003269.
• 14. Al-Samkari H, Karp Leaf RS, Dzik WH, et al. COVID and coagulation: bleeding and thrombotic manifestations of SARS-CoV2 infection. Blood. 2020; 23; 136(4): 489-500. doi: 10.1182/blood.2020006520.
• 15. Henry BM, Aggarwal G, Wong J, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med. 2020; 38(9): 1722–6. doi: 10.1016/j.ajem.2020.05.073.
• 16. Zhang ZL, Hou YL, Li DT, Li FZ. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand. J Clin Lab Invest. 2020; 80(6): 441-7. doi: 10.1080/00365513.2020.1768587.
• 17. Long H, Nie L, Xiang X, et al. D-Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID-19 and Poor Prognosis. Biomed Res Int. 2020: 6159720. doi: 10.1155/2020/6159720.
• 18. Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020; 84: 106504. doi: 10.1016/j.intimp.2020.106504.
• 19. Lippi G, Lavie CJ, Sanchis-Gomar F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): evidence from a meta-analysis. Prog Cardiovasc Dis. 2020; 63(3): 390-391. doi: 10.1016/j.pcad.2020.03.001.
• 20. Velavan TP, Meyer CG. Mild versus severe COVID-19: laboratory markers. Int J Infect Dis. 2020; 95: 304-7. doi: 10.1016/j.ijid.2020.04.061.
• 21. Sivaloganathan H, Ladikou EE, Chevassut T. COVID-19 mortality in patients on anticoagulants and antiplatelet agents. Br J Haematol. 2020; 190(4): 192-5. doi: 10.1111/bjh.16968.
• 22. Egan G, Hughes CA, Ackman ML. Drug interactions between antiplatelet or novel oral anticoagulant medications and antiretroviral medications. Ann Pharmacother. 2014; 48(6): 734-40. doi: 10.1177/1060028014523115.
• 23. Agarwal S, Agarwal SK. Lopinavir-Ritonavir in SARS-CoV-2 Infection and Drug-Drug Interactions with Cardioactive Medications. Cardiovasc Drugs Ther. 2020; 12; 1-14. doi: 10.1007/s10557-020-07070-1.
• 24. Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5): 2000547. doi: 10.1183/13993003.00547-2020