Lancet Haematol: Dynamic monitoring of blood and clotting parameters provides more accurate and convenient assessment of the condition and prognosis of PATIENTs with COVID-19

!---- 2019 coronavirus disease (COVID-19) has become endemic worldwide, posing a serious threat to human healthChanges in hematological characteristics in patients withCOVID-19 are becoming an important feature of the diseaserecently, Hu Yu's team at Concord Hospital, affiliated with Huazhong University of Science and Technology, studied the hematological characteristics and related risk factors of PATIENTs with COVID-19the retrospective cohort study included 380 PATIENTs admitted to Wuhan Concord Hospital, extracted demographic data, clinical data, laboratory data, treatment data and outcome data from electronic medical records, and compared patients with moderate to severe and critical conditions with risk factors associated with critical illness and adverse prognosisfocused on the hematology and clotting parameters of patients with moderate to severe and critical COVID-19 patients, and analyzed the blood clotting changes of non-survivors, and found that the incidence of coagulation dysfunction in non-survivors was very high, such as thrombosis complications, bleeding, etccombined laboratory indicators such as neutrophil to lymphocyte ratio (neutrophil to lymphocyte ratio, NLR), platelet count, D-dipolymer, and clotting progenitor time provide clues to poor prognosisin addition, the study used a linear hybrid model to analyze dynamic hematology and clotting parameters, and used sepsis-induced coagulation function scoring system SIC (sepsis-induced coagulopathy) and the International Thrombosis and HemophilisAssociation Association published the diffuse intravascular clotting scoring system DIC (intravascular coagulation) to dynamically monitor and evaluate 20 critically ill patientsstudy found that in 380 PATIENTs with COVID-19, platelet reduction (plateplate count, platelet count 100 x 109/L, the incidence was significantly higher in critical group (42 s.49%, 86) and significantly higher in the critical group (20 s.1) 4%, 145) and the mild group (9.6% ,149), (P 0.0001), while the lymphocyte count and eoseophilic cell count were significantly lower than those in the severe and mild groups (P.0001)coagulation algemogenic time, D-dipolymer and fibrin degradation products increasesignificantly with the severity of the disease (P 0.0001)multi-factor analysis showed that death was associated with the ratio of neutrophils to lymphocytes (NLR: 9.13, OR: 5.39 (95% CI 1.70-17.13), p.0.0042), associated with platelet reduction (platelet count 100 x 109/L, OR: 8.33 (2.56-27.15) p-0.00045); s;OR 4.94 (1.50-16.25) p.0094; associated with D-dimpolymer elevation (?2mg/L; OR:4.41 .1.06-18.30) p.041)thrombosis and bleeding events are common complications in deceased patients (19, 35%, 55)finally, due to the lack of some laboratory test data, the study analyzed the dynamic monitoring results of hematology and clotting indicators of only 20 of the 86 critically ill patients (12 survived and 8 died), and used SIC scoring and DIC scores respectively, and found that the SIC scoring system could indicate that patients may have clotting dysfunction earlierstudies have concluded that clotting dysfunction is a complication that cannot be ignored and an important potential cause of death in critical patients with COVID-19dynamic monitoring of blood and clotting parameters, such as neutrophil-lymphocyte ratio (NLR), platelet counting, D-dipolymer, coagulation progenitor time, etc., can accurately and conveniently evaluate the condition of COVID-19 patients and predict the patient's prognosissepsis-induced clotting function scoring system (SIC) may be an effective tool for doctors to assess and manage critically ill patientsNote: The SIC system was proposed by the DIC Committee for Science and Standardization to identify the early stages of DIC, facilitate early identification of clotting dysfunction and the implementation of anticoagulant therapy in clinical work