Blood coagulation parameter abnormalities in hospitalized patients with confirmed COVID-19 in Ethiopia.

Shambel Araya,Abebe Edao Negeso,Asegdew Atlaw,Zemenu Tamir,Abebe Hordofa,Aschalew Aytenew,Moges Wordofa,Yakob Gebregziabher Tsegay,Mahlet Cheru,Tirhas Niguse,Mintesnot Aragaw Mamo,Elizabeth S Mayne

doi:10.1371/journal.pone.0252939

Abstract

Coagulopathy and thromboembolic events are among the complications of Corona Virus disease 2019 (COVID-19). Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity. The aim of this study was to analyze coagulation profiles of hospitalized COVID-19 patients in Addis Ababa, Ethiopia. This prospective cross-sectional study was conducted among 455 Covid-19 patients admitted at Millennium COVID-19 care and treatment center, Addis Ababa, Ethiopia from July 1- October 23, 2020. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and International normalized ratio (INR) were determined on HUMACLOT DUE PLUS® coagulation analyzer (Wiesbaden, Germany). In all statistical analysis of results, p<0.05 was defined as statistically significant. A prolonged prothrombin time was found in 46.8% of study participants with COVID-19 and a prolonged prothrombin time and elevated INR in 53.3% of study subjects with severe and 51% of critically COVID patients. Thrombocytopenia was detected in 22.1% of COVID-19 patients. 50.5% and 51.3% of COVID-19 patients older than 55 years had thrombocytopenia and prolonged APTT respectively. In this study, prolonged prothrombin time and elevated INR were detected in more than 50% of severe and critical COVID-19 patients. Thrombocytopenia and prolonged APTT were dominant in COVID-19 patients older than 55 years. Thus, we recommend emphasis to be given for monitoring of platelet count, PT, APTT and INR in hospitalized and admitted COVID-19 patients.

Highlights

Coronavirus disease 2019 (COVID-19) is caused by a novel beta corona virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
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Thrombocytopenia and prolonged Activated Partial Thromboplastin Time (APTT) were dominant in COVID-19 patients older than 55 years

Summary

Introduction

Coronavirus disease 2019 (COVID-19) is caused by a novel beta corona virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. There have been 99,204 confirmed cases of COVID-19 with 1,518 deaths in Ethiopia [2]. Most of the patients have a favorable prognosis, but some rapidly progress to severe respiratory distress syndrome, coagulation dysfunction and multiple organ failures [3, 4]. The pathophysiology and the underlining mechanisms of clinical manifestations remain unclear, thrombo inflammation and cytokine storm are clearly established components in Severe Acute Respiratory Distress Syndrome (SARS) of COVID-19 [5,6,7,8]. Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity.

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Conclusion