Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants
BACKGROUND: Despites its benefits, as one of COVID-19 principal treatments, anticoagulant raises a significant concern regarding the anticoagulant-related thrombocytopenia. However, up to date, there is lack of study examining anticoagulantinduced thrombocytopenia during COVID-19, hence this study w...
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| Format: | Article |
| Language: | English |
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Secretariat of The Indonesian Biomedical Journal
2023-02-01
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| Series: | Indonesian Biomedical Journal |
| Online Access: | https://inabj.org/index.php/ibj/article/view/2045 |
| _version_ | 1797900225741848576 |
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| author | Ami Ashariati Prayoga Siprianus Ugroseno Yudho Bintoro Pradana Zaky Romadhon Muhammad Noor Diansyah Putu Niken Ayu Amrita Merlyna Savitri Choirina Windradi Krisnina Nurul Widiyastuti |
| author_facet | Ami Ashariati Prayoga Siprianus Ugroseno Yudho Bintoro Pradana Zaky Romadhon Muhammad Noor Diansyah Putu Niken Ayu Amrita Merlyna Savitri Choirina Windradi Krisnina Nurul Widiyastuti |
| author_sort | Ami Ashariati Prayoga |
| collection | DOAJ |
| description | BACKGROUND: Despites its benefits, as one of COVID-19 principal treatments, anticoagulant raises a significant concern regarding the anticoagulant-related thrombocytopenia. However, up to date, there is lack of study examining anticoagulantinduced thrombocytopenia during COVID-19, hence this study was conducted to determine the factors inducing anticoagulant-induced thrombocytopenia in COVID-19 patients.
METHODS: An observational cross-sectional study of 106 anticoagulant-treated COVID-19 subjects was conducted. Blood serum was drawn from subjects, then platelets, prothrombin time (PT), activated partial thromboplastin (aPPT), international ratio (INR), D-dimer, ferritin, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP), were measured. For thrombocytopenia risk assessment, the 4T score was calculated. To assess the risk of thrombocytopenia. Statistical analysis using Chi-square and Mann-Whitney U test were performed and followed by multivariate analysis to examine the correlation among the thrombocytopenia risk factors.
RESULTS: Significant differences were identified in the length of stay (LOS) (p=0.04), disease severity (p=0.021), sepsis (p=0.006), hs-CRP (p=0.003), and mortality rate (p=0.028) between thrombocytopenia and nonthrombocytopenia groups. A multivariate analysis through linear and logistic regression disclosed an increase in hs-CRP (OR=-0.29; p=0.045) and sepsis (OR=4.32; p=0.03)
that precipitate the thrombocytopenia events.
CONCLUSION: In severe and critically ill COVID-19 patients, the occurrence of thrombocytopenia was followed by an increase in inflammatory parameters such as D-dimer, fibrinogen, ferritin, hs-CRP and prolonged coagulation. The increase in hs-CRP and sepsis may raise the risk of thrombocytopenia, especially in severe and crtically ill cases of COVID-19.
KEYWORDS: COVID-19, anticoagulant, thrombocytopenia, inflammation, infectious disease |
| first_indexed | 2024-04-10T08:41:32Z |
| format | Article |
| id | doaj.art-6f308c5440754dada360b3a7cbb1bc68 |
| institution | Directory Open Access Journal |
| issn | 2085-3297 2355-9179 |
| language | English |
| last_indexed | 2024-04-10T08:41:32Z |
| publishDate | 2023-02-01 |
| publisher | Secretariat of The Indonesian Biomedical Journal |
| record_format | Article |
| series | Indonesian Biomedical Journal |
| spelling | doaj.art-6f308c5440754dada360b3a7cbb1bc682023-02-23T01:24:54ZengSecretariat of The Indonesian Biomedical JournalIndonesian Biomedical Journal2085-32972355-91792023-02-01151778410.18585/inabj.v15i1.2045498Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving AnticoagulantsAmi Ashariati Prayoga0Siprianus Ugroseno Yudho Bintoro1Pradana Zaky Romadhon2Muhammad Noor Diansyah3Putu Niken Ayu Amrita4Merlyna Savitri5Choirina Windradi6Krisnina Nurul Widiyastuti7Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 601322Department of Internal Medicine, Universitas Airlangga Hospital, Kampus C Unair, Jl. Mulyorejo, Surabaya 60115Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo No.47, Surabaya 60132BACKGROUND: Despites its benefits, as one of COVID-19 principal treatments, anticoagulant raises a significant concern regarding the anticoagulant-related thrombocytopenia. However, up to date, there is lack of study examining anticoagulantinduced thrombocytopenia during COVID-19, hence this study was conducted to determine the factors inducing anticoagulant-induced thrombocytopenia in COVID-19 patients. METHODS: An observational cross-sectional study of 106 anticoagulant-treated COVID-19 subjects was conducted. Blood serum was drawn from subjects, then platelets, prothrombin time (PT), activated partial thromboplastin (aPPT), international ratio (INR), D-dimer, ferritin, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP), were measured. For thrombocytopenia risk assessment, the 4T score was calculated. To assess the risk of thrombocytopenia. Statistical analysis using Chi-square and Mann-Whitney U test were performed and followed by multivariate analysis to examine the correlation among the thrombocytopenia risk factors. RESULTS: Significant differences were identified in the length of stay (LOS) (p=0.04), disease severity (p=0.021), sepsis (p=0.006), hs-CRP (p=0.003), and mortality rate (p=0.028) between thrombocytopenia and nonthrombocytopenia groups. A multivariate analysis through linear and logistic regression disclosed an increase in hs-CRP (OR=-0.29; p=0.045) and sepsis (OR=4.32; p=0.03) that precipitate the thrombocytopenia events. CONCLUSION: In severe and critically ill COVID-19 patients, the occurrence of thrombocytopenia was followed by an increase in inflammatory parameters such as D-dimer, fibrinogen, ferritin, hs-CRP and prolonged coagulation. The increase in hs-CRP and sepsis may raise the risk of thrombocytopenia, especially in severe and crtically ill cases of COVID-19. KEYWORDS: COVID-19, anticoagulant, thrombocytopenia, inflammation, infectious diseasehttps://inabj.org/index.php/ibj/article/view/2045 |
| spellingShingle | Ami Ashariati Prayoga Siprianus Ugroseno Yudho Bintoro Pradana Zaky Romadhon Muhammad Noor Diansyah Putu Niken Ayu Amrita Merlyna Savitri Choirina Windradi Krisnina Nurul Widiyastuti Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants Indonesian Biomedical Journal |
| title | Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants |
| title_full | Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants |
| title_fullStr | Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants |
| title_full_unstemmed | Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants |
| title_short | Increased hs-CRP and Sepsis Influence the Occurrence of Thrombocytopenia in Severe and Critically Ill COVID-19 Patients Receiving Anticoagulants |
| title_sort | increased hs crp and sepsis influence the occurrence of thrombocytopenia in severe and critically ill covid 19 patients receiving anticoagulants |
| url | https://inabj.org/index.php/ibj/article/view/2045 |
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