Evaluation of coagulation parameters: Coronavirus disease 2019 (COVID-19) between survivors and nonsurvivors (original) (raw)

Coagulation Profile in COVID-19 Patients and its Relation to Disease Severity and Overall Survival: A Single-Center Study

British Journal of Biomedical Science

Objectives: This study aims to investigate hemostatic changes in patients with coronavirus disease (COVID-19) and their relationship to disease severity and survival.Methods: This study included 284 patients with COVID-19 who attended the Security Forces Hospital, Makkah, Saudi Arabia between October 2020 and March 2021, and retrospectively reviewed their demographic, radiological, and laboratory findings. The coagulation profile was assayed at the time of diagnosis for platelet counts using an automated hematology analyzer; Sysmex XN2000 while international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, factor VIII, ristocetin cofactor (RiCoF), and von Willebrand factor antigen (VWF-Ag) were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®).Results: In this study, 32.3% of the cases had severe disease, while 8.8% of the cases died. D-dimer, factor VIII, and RiCoF were the only independent predictors of di...

Coagulation Parameters: An Efficient Measure for Predicting the Prognosis and Clinical Management of Patients with COVID-19

Journal of Clinical Medicine

Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of coronavirus disease 2019 (COVID-19) in Wuhan, China, the current pandemic has affected more than 25.3 million people worldwide. The aim of this study was to evaluate the relationship between coagulation abnormalities and prognosis in a cohort of patients with COVID-19. Methods. We performed a retrospective cohort study of 3581 patients admitted to Hospital La Paz (Madrid, Spain) due to respiratory infection by severe acute respiratory syndrome coronavirus from the beginning of the current pandemic to 15 July 2020. Results. Of the 3581 study patients, 48.94% were men, and 19.80% were healthcare workers. The median age was 62 years. Compared with the survivors, the non-survivors had lower prothrombin activity (82.5 (Interquartile range—IQR, 67–95) vs. 95.25 (IQR, 87–104) for non-survivors and survivors, respectively; p < 0.001), higher fibrinogen levels (748.5—IQR, 557–960) vs. 572.75 (IQR...

Differences between biochemical, hematological and coagulation parameters among patients with mild and severe COVID-19

Sanamed

Introduction: Covid-19 is an infectious disease caused by the severe acute respiratory syndrom coronavirus 2 and causes a series of respiratory symptoms. Considering the appearance and development of symptoms, the course of Covid-19 can go from mild to severe. Depending on the course of Covid-19, the laboratory parameters change a lot, trying to defend the organism against the foreign pathogen and all the changes it causes. Therefore, the aim of this study is to observe the differences between biochemical, hematological and coagulation parameters depending on the disease stage of Covid-19 patients. Material and methods: We conducted cross-sectional study which included 160 Covid-19 patients from Sarajevo, Bosnia and Herzegovina. Biochemical, hematological and coagulation analyzes were performed. Results: Covid-19 patients with a severe clinical course have higher average values of fibrinogen (6.53 ± 4.47, p < 0.001), D-dimer (6.89 ± 7.81, p < 0.001), APTT (32.05 ± 5.96, p = 0....

Coagulation factors as potential predictors of COVID-19 patient outcomes

Medical Journal of Indonesia

BACKGROUND Causes of death and length of hospitalization in patients with COVID-19 have been associated with coagulopathy. The coagulopathy mechanism involves the process of coagulation and endothelial damage triggered by an inflammatory response of the SARS-CoV-2 infection due to excessive release of proinflammatory cytokines. This study aimed to determine the association of coagulation factors as potential predictors of COVID-19 patient outcomes. METHODS This retrospective study was performed on 595 patients at Wahidin Sudirohusodo Hospital, Makassar, from June 2020 to June 2021. Participants were recruited using total sampling and assessed for COVID-19 severity using the World Health Organization classification and coagulation factors (D-dimer, fibrinogen, thrombocyte, and prothrombin time [PT]). Patient outcome assessments were survival and length of hospitalization. RESULTS We found a significant sex-based disparity, with a higher COVID-19 incidence in males. Severe cases were ...

Pattern of Coagulation Parameters in Patients with COVID-19 - a Single Centre Based Study

2020

Objective: To determine prognostic significance of coagulation parameters in patients with COVID-19. Study Design: A prospective comparative study. Place and Duration of Study: Department of Haematology, Army Medical College, Pak Emirates Military Hospital, Rawalpindi, from Apr to May 2020. Methodology: A total of 248 patients diagnosed with COVID-19 of all ages irrespective of gender were enrolled. Their coagulation parameters were assessed and comparisons were made between patients with mild/moderate (non-critical) disease against those with severe/critically ill (critical).Performa was designed and data was analyzed using SPSS 26. Results: Patients in the critical group revealed constantly elevated levels of Domain-dimer (D-dimer, ng/ml -73.7% vs. 50.5%, 89.5% vs. 39%, 78.9 vs. 41.9%, 77.8% vs. 42%), increased activated partial thromboplastin time (APTT - 34.68 vs. 32.17 sec, 38.84 vs. 32.40 sec, 37.58 vs. 32.50 sec , 37.94 vs. 32.61 sec) and prothrombin time (PT - 14.26 vs. 14.2...

Coagulation parameters abnormalities and their relation to clinical outcomes in hospitalized and severe COVID-19 patients: prospective study

Scientific Reports

There has been growing attention toward the predictive value of the coagulation parameters abnormalities in COVID-19. The aim of the study was to investigate the role of coagulation parameters namely Prothrombin concentration (PC), activated Partial thromboplastin Time (aPTT), D-Dimer (DD), Anti Thrombin III (ATIII) and fibrinogen (Fg) together with hematological, and biochemical parameters in predicting the severity of COVID-19 patients and estimating their relation to clinical outcomes in hospitalized and severe COVID-19 Patients. In a prospective study, a total of 267 newly diagnosed COVID-19 patients were enrolled. They were divided into two groups; hospitalized group which included 144 patients and non-hospitalized group that included 123 patients. According to severity, the patients were divided into severe group which included 71 patients and non-severe group that included 196 patients who were admitted to ward or not hospitalized. Clinical evaluation, measurement of coagulat...

Can disseminated intravascular coagulation scores predict mortality in COVID-19 patients?

2021

Objectives Complications related to coronavirus disease 2019 (COVID-19) may lead to disseminated intravascular coagulation (DIC), which has been reported to be among the known causes of mortality in such patients. This study aims to analyse the incidence of DIC in COVID-19 non-survivors and to assess the association between DIC and its comorbidities. Methods The medical records of 154 non-survivors of COVID-19, hospitalised between April 2020 and July 2020, were retrospectively analysed. The International Society on Thrombosis and Haemostasis (ISTH) criteria for DIC were applied to identify the occurrence of coagulopathy. The receiver-operating characteristic (ROC) analysis was used to assess the association between DIC and its comorbidities. Results Out of 154 non-survivors, non-overt DIC was observed in 94.8% of the patients, whereas only 5.2% fulfilled the overt criteria of DIC with a mean age 64.6 years. The mortality rate was 4.5 times higher among men than women. The D-dimer l...

The Use of Coagulation Markers to Evaluate the Effectiveness of Coronavirus Disease (COVID-19) Therapeutic Protocols

Materia Socio Medica, 2023

Background: Patients infected by coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), display various symptoms and severity of the clinical picture. Thus, the therapy and pathophysiology of this disease are a dilemma for health professionals and scientists. Objective: This paper aims to evaluate the effectiveness of therapeutic protocols (the use of anticoagulants) in the treatment of COVID-19 patients of various severity of the clinical picture by monitoring coagulation markers (PT, INR, aPTT and D-dimer), as well as the impact of the type and number of comorbidities patients had on these markers. Methods: A total of 200 patients with a mild (n=76), moderate (n=70) or severe (n=54) clinical picture was included. Coagulation markers [PT (prothrombin time), INR (international normalized ratio), aPTT (activated partial thromboplastin time), D-dimer] were examined on three occasions: twice during hospitalization and once after hospital discharge. Anticoagulants used intrahospital were fraxiparine, rivaroxaban or unfractionated heparin. Posthospital, patients were taking either rivaroxaban or did not use any anticoagulants. For statistical analysis, SPSS 26.0 and Microsoft Excel 2019 were used, with a level of significance of α=0.05. Nonparametric tests (Kruskal-Wallis, Wilcoxon Signed-Rank and Bonferroni) were applied and effect size (ES) was calculated. Results: Three anticoagulants used intrahospital caused a significant decrease in PT, INR and D-dimer and a significant increase in aPTT, especially in patients with a severe clinical picture, but the ES was the biggest with fraxiparine, then rivaroxaban, and lastly unfractionated heparin. Posthospital, rivaroxaban caused a significant decrease in PT, INR and D-dimer and a significant increase in aPTT, especially in patients with a severe clinical picture. Hypertension was the most common comorbidity in all patients, as well as in patients with a severe clinical picture. There was a statistically significant impact of the number of comorbidities patients had on D-dimer, and none on PT, INR and aPTT, but the highest number of comorbidities was in patients with a severe clinical picture. Conclusion: The use of anticoagulants, especially fraxiparine intrahospital and rivaroxaban posthospital, is justified in most COVID-19 cases as there is a significant correlation between this disease’s pathophysiology and the coagulation process. There is also a positive correlation between the severity of the clinical picture and the number of comorbidities patients have.

Coagulation biomarkers and coronavirus disease 2019 phenotyping: a prospective cohort study

Thrombosis Journal, 2023

Background Because severe acute respiratory syndrome coronarivus 2 (SARS-CoV-2) leads to severe conditions and thrombus formation, evaluation of the coagulation markers is important in determining the prognosis and phenotyping of patients with COVID-19. Methods In a prospective study that included 213 COVID-19 patients admitted to the intensive care unit (ICU) the levels of antithrombin, C-reactive protein (CRP); factors XI, XII, XIII; prothrombin and D-dimer were measured. Spearman's correlation coefficient was used to assess the pairwise correlations between the biomarkers. Hierarchical and non-hierarchical cluster analysis was performed using the levels of biomarkers to identify patients´ phenotypes. Multivariate binary regression was used to determine the association of the patient´s outcome with clinical variables and biomarker levels. Results The levels of factors XI and XIII were significantly higher in patients with less severe COVID-19, while factor XIII and antithrombin levels were significantly associated with mortality. These coagulation biomarkers were associated with the in-hospital survival of COVID-19 patients over and above the core clinical factors on admission. Hierarchical cluster analysis showed a cluster between factor XIII and antithrombin, and this hierarchical cluster was extended to CRP in the next step. Furthermore, a non-hierarchical K-means cluster analysis was performed, and two phenotypes were identified based on the CRP and antithrombin levels independently of clinical variables and were associated with mortality. Conclusion Coagulation biomarkers were associated with in-hospital survival of COVID-19 patients. Lower levels of factors XI, XII and XIII and prothrombin were associated with disease severity, while higher levels of both CRP and antithrombin clustered with worse prognosis. These results suggest the role of coagulation abnormalities in the development of COVID-19 and open the perspective of identifying subgroups of patients who would benefit more from interventions focused on regulating coagulation.

Parameters of Coagulation in COVID-19 Patients: A Correlation with Clinical Severity

Journal of Medical Microbiology and Infectious Diseases

Introduction: COVID-19 infection can be complicated by coagulation derangement and a high risk of thromboembolic episodes. Our study aimed to investigate coagulation parameters in COVID-19 patients and their correlation with clinical severity. Methods: We analyzed coagulation parameters PT, APTT, D-Dimer, and Fibrinogen in 98 RT-PCR-confirmed COVID-19 patients admitted to the