Abstract
Purpose: The coronavirus disease (COVID-19) pandemic poses a global threat, and identification of its prognostic biomarkers could prove invaluable. Fibrinogen (FIB) could be one such indicator as coagulation and fibrinolysis abnormalities are common among COVID-19 patients. We examined the role of FIB levels in the prognosis of COVID-19.Methods: This retrospective cohort study enrolled 1,643 COVID-19 patients from the Leishenshan Hospital in Wuhan, China. The follow-up was conducted from February 8, 2020 to April 15, 2020. The cohort was divided into three groups according to the FIB level on admission, and associations with mortality and disease severity were determined using Cox and logistic regression analyses, respectively. Further, Kaplan–Meier (K–M) analyses by log-rank tests were used to assess the survival of patients with varying FIB levels.Results: Patients with FIB < 2.2 g/L [hazard ratio (HR): 9.02, 95% confidence interval (CI): 1.91–42.59, P = 0.006] and >4.2 g/L (HR: 4.79, 95% CI: 1.14–20.20, P = 0.033) showed higher mortality risks compared to those with FIB between 2.2 and 4.2 g/L. The survival curves showed similar results in K–M analyses (P < 0.001). Additionally, an elevated FIB level was associated with a greater risk of developing critical disease (odds ratio: 2.16, 95% CI: 1.04–4.46, P = 0.038) than a FIB level within the normal range.Conclusion: Abnormal FIB levels may be associated with mortality risk among COVID-19 patients and could predict critical disease development. Thus, assessment of FIB levels may assist in determining the prognosis of COVID-19 patients.
Highlights
The coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China in December 2019 and has since become a pandemic [1,2,3,4]
(age, creatine kinase, total bilirubin, creatinine, white blood cell count, lymphocyte count, cardiovascular disease history), the multivariate analysis revealed that patients with FIB < 2.2 g/L [hazard ratio (HR): 9.02, 95% confidence Interval (CI): 1.91–42.59, P = 0.006] and FIB > 4.2 g/L
The result suggests a negative correlation between FIB levels and thrombin time (TT). In this retrospective cohort study, abnormal FIB levels on admission were associated with a greater risk of COVID-19related mortality compared with normal FIB levels
Summary
The coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China in December 2019 and has since become a pandemic [1,2,3,4]. As of March 26, 2021, confirmed COVID-19 cases were reported in over 200 countries and regions, with over 125 million infected people and over 2 million attributable deaths [5]. The association of SARS and MERS with thrombotic complications and coagulation manifestations suggests the importance of coagulation disturbances in COVID-19 patients [9, 10]. Most COVID-19 infections are mild and self-healing, some can cause serious complications such as acute respiratory distress syndrome (ARDS), shock, multiple system organ failure, and even death [11,12,13]. Researching factors related to potential deterioration in such cases is of great importance
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