A study on coagulation profile and clinical outcomes in hospitalized COVID-19 patients in a tertiary care hospital in South India

Abstract

Introduction: Coagulation abnormalities are a common occurrence in patients with COVID-19, of particular significance is the relationship between D-dimer levels and clinical outcomes. A higher D-dimer level at admission is found to have a poor clinical outcome with increased severity of the disease and increased mortality. Aim and Objectives: To analyze the coagulation profile and its relation to the outcome of patients admitted with COVID-19 pneumonia in a tertiary care center in South India. Subjects and Methods: We conducted a prospective observational study looking at the admission D-dimer, prothrombin time (PT)/international normalized ratio (INR), and platelet levels in 102 admitted COVID-19 patients from February 2021 to January 2022. The relationship between these parameters on admission and the clinical outcome in the form of oxygen requirement, duration of stay, survival, and need for domiciliary oxygen was studied. Discussion and Results: Higher D-dimer levels at admission were associated with poor survival and longer duration of hospital stay with increased requirement of oxygen support. There was a significant correlation between the mean admission D-dimer level and the need for supplemental oxygen (P < 0.05) with patients having a higher D-dimer level at admission (D-dimer of moderate and severe categories: 0.62 ± 0.88 μg/mL and 2.46 ± 4.22 μg/mL, respectively) requiring a higher concentration of oxygen in the form of noninvasive ventilation/high-flow nasal cannula. Furthermore, PT, INR, and platelet count on admission were not useful in predicting the clinical course, oxygen requirement, and overall survival in the study population. Conclusion: Admission levels of D-Dimer can predict the clinical course and outcome of COVID-19 patients.