COVID-19-associated coagulopathy and acute kidney injury in critically ill patients
ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care u...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2023-09-01
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| Series: | Einstein (São Paulo) |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082023000100229&tlng=en |
| _version_ | 1797681823328763904 |
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| author | Bruno Caldin da Silva Ricardo Luiz Cordioli Bento Fortunato Cardoso dos Santos João Carlos de Campos Guerra Roseny dos Reis Rodrigues Guilherme Martins de Souza Carolina Ashihara Thais Dias Midega Niklas Söderberg Campos Bárbara Vieira Carneiro Flávia Nunes Dias Campos Hélio Penna Guimarães Gustavo Faissol Janot de Matos Valdir Fernandes de Aranda Leonardo José Rolim Ferraz Thiago Domingos Corrêa |
| author_facet | Bruno Caldin da Silva Ricardo Luiz Cordioli Bento Fortunato Cardoso dos Santos João Carlos de Campos Guerra Roseny dos Reis Rodrigues Guilherme Martins de Souza Carolina Ashihara Thais Dias Midega Niklas Söderberg Campos Bárbara Vieira Carneiro Flávia Nunes Dias Campos Hélio Penna Guimarães Gustavo Faissol Janot de Matos Valdir Fernandes de Aranda Leonardo José Rolim Ferraz Thiago Domingos Corrêa |
| author_sort | Bruno Caldin da Silva |
| collection | DOAJ |
| description | ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population. |
| first_indexed | 2024-03-11T23:50:36Z |
| format | Article |
| id | doaj.art-d591a90cdb5c49138d819a61a426c151 |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-03-11T23:50:36Z |
| publishDate | 2023-09-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-d591a90cdb5c49138d819a61a426c1512023-09-19T07:43:06ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852023-09-012110.31744/einstein_journal/2023ao0119COVID-19-associated coagulopathy and acute kidney injury in critically ill patientsBruno Caldin da Silvahttps://orcid.org/0000-0001-9568-0974Ricardo Luiz Cordiolihttps://orcid.org/0000-0001-7521-399XBento Fortunato Cardoso dos Santoshttps://orcid.org/0000-0002-4662-1959João Carlos de Campos Guerrahttps://orcid.org/0000-0002-4156-529XRoseny dos Reis Rodrigueshttps://orcid.org/0000-0002-3796-5952Guilherme Martins de Souzahttps://orcid.org/0000-0002-0643-2723Carolina Ashiharahttps://orcid.org/0000-0002-6961-8509Thais Dias Midegahttps://orcid.org/0000-0002-1010-3711Niklas Söderberg Camposhttps://orcid.org/0000-0002-4768-0299Bárbara Vieira Carneirohttps://orcid.org/0000-0001-7858-9730Flávia Nunes Dias Camposhttps://orcid.org/0000-0002-5406-2165Hélio Penna Guimarãeshttps://orcid.org/0000-0001-5523-1015Gustavo Faissol Janot de Matoshttps://orcid.org/0000-0001-9996-7040Valdir Fernandes de Arandahttps://orcid.org/0000-0002-3246-4358Leonardo José Rolim Ferrazhttps://orcid.org/0000-0003-1822-1568Thiago Domingos Corrêahttps://orcid.org/0000-0001-9546-3910ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082023000100229&tlng=enAcute kidney injuryCOVID-19SARS-CoV-2Coronavirus infectionsThrombosisBlood coagulationIntensive care units |
| spellingShingle | Bruno Caldin da Silva Ricardo Luiz Cordioli Bento Fortunato Cardoso dos Santos João Carlos de Campos Guerra Roseny dos Reis Rodrigues Guilherme Martins de Souza Carolina Ashihara Thais Dias Midega Niklas Söderberg Campos Bárbara Vieira Carneiro Flávia Nunes Dias Campos Hélio Penna Guimarães Gustavo Faissol Janot de Matos Valdir Fernandes de Aranda Leonardo José Rolim Ferraz Thiago Domingos Corrêa COVID-19-associated coagulopathy and acute kidney injury in critically ill patients Einstein (São Paulo) Acute kidney injury COVID-19 SARS-CoV-2 Coronavirus infections Thrombosis Blood coagulation Intensive care units |
| title | COVID-19-associated coagulopathy and acute kidney injury in critically ill patients |
| title_full | COVID-19-associated coagulopathy and acute kidney injury in critically ill patients |
| title_fullStr | COVID-19-associated coagulopathy and acute kidney injury in critically ill patients |
| title_full_unstemmed | COVID-19-associated coagulopathy and acute kidney injury in critically ill patients |
| title_short | COVID-19-associated coagulopathy and acute kidney injury in critically ill patients |
| title_sort | covid 19 associated coagulopathy and acute kidney injury in critically ill patients |
| topic | Acute kidney injury COVID-19 SARS-CoV-2 Coronavirus infections Thrombosis Blood coagulation Intensive care units |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082023000100229&tlng=en |
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