• Mirza Kovačević, Nermina Rizvanović, Šabanović AdilovićAdisaADepartment of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina., and Senada Čaušević.
• Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
• Med Glas (Zenica). 2023 Aug 1; 20 (2): 142147142-147.

AbstractAim To determine the relationship between coagulation disorders and septic condition in COVID-19 critically ill patients. Methods Data from 99 patients who presented with COVID-19 acute hypoxemic respiratory failure (CAHRF) were divided into two groups: Group 1- patients who developed sepsis, and Group 2 - patients who developed septic shock. Age, sex, comorbidities, quick Sequential Organ Failure Assessment (qSOFA) score, vasopressor and inotrope requirement, laboratory findings (platelets, neutrophils, lymphocytes, procalcitonin - PCT, C-reactive protein, fibrinogen, D-dimer, sepsis-induced coagulopathy - SIC, and disseminated intravascular coagulation - DIC score) were recorded on the day of admission and on the day of starting invasive mechanical ventilation. The primary outcome was to establish COVID-19 associated coagulopathy with sepsis and septic shock; the secondary outcome measure was incidence of coagulopathy in septic COVID-19 critically ill patients. Results The most common coagulation abnormality was international normalized ratio (INR) (p=0.019) for Group 2, followed by the values of inflammatory parameters PCT (p=0.002) and lymphocytes (p=0.011) also for Group 2. The statistical significance of SIC score was observed for both groups (p=0.007) and p=0.012, respectively. Norepinephrine (p=0.000) and dobutamine (p=0.000) for Group 2, qSOFA for both groups (p = 0.000) were statistically significant. Conclusion The observed coagulation abnormalities met the criteria for a SIC diagnosis, therefore, the management of coagulation disorders at this stage of the disease should follow the management of a septic condition.Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

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