Abstract
Objective: This study aimed to describe the dynamic changes of coagulation parameters and evaluate the relationship between longitudinal coagulation parameters abnormalities and prognosis of COVID-19 patients.Methods: We performed a retrospective study of 1131 COVID-19 patients. Longitudinal coagulation parameters and clinical outcomes were analyzed.Results: Abnormal coagulation parameters were observed in patients with COVID-19, both at hospital admission (INR 2.3%, PT 7.9%, APTT 15.4%, TT 0.9%, FDP 2.3%, D-dimer 19.7%) and peak hospitalization (INR 4.8%, PT 13.4%, APTT 25.6%, TT 2.7%, FDP 10.4%, D-dimer 31.5%). Compared with non-severe patients with COVID-19, severe patients had a slightly higher INR, PT, APTT, whereas remarkably higher FDP and D-dimer (p < 0.05). On multivariate analysis, age > 60 years, male, obesity, comorbidity, abnormal D-dimer on hospital admission, and abnormal peak hospitalization PT, APTT, FDP and D-dimer were associated with COVID-19 severity. The extreme coagulation parameters abnormalities (PT > 16s, FDP > 50 ug/ml, and D-dimer > 5 ug/ml) were associated with a significantly higher mortality.Conclusion: Longitudinal coagulation parameters abnormalities are common in patients with COVID-19, and associated with disease severity and mortality. Monitoring coagulation parameters is advisable to improve the management of patients with COVID-19.
Highlights
Coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1], is a new type of infectious respiratory disease, and has become an ongoing global pandemic with a profound impact on society and the global economy
This study aimed to describe the dynamic changes of coagulation parameters and evaluate the relationship between longitudinal coagulation parameters abnormalities and prognosis of COVID-19 patients
This study aimed to describe the dynamic changes of coagulation parameters during hospitalization, and evaluate the association between longitudinal coagulation parameters abnormalities and clinical outcomes of COVID-19 patients
Summary
Coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1], is a new type of infectious respiratory disease, and has become an ongoing global pandemic with a profound impact on society and the global economy. As of 22 November 2020, there have been over 57.8 million cases and 1.3 million deaths reported globally since the start of the pandemic [2]. 20% of COVID-19 patients present coagulation abnormalities, which occur more commonly in the severe and critically ill cases [4]. Coagulopathy has been reported in up to 50% of severe COVID-19 patients, in whom disseminated intravascular coagulation (DIC) has been reported in more than 70% of the patients [5]. Tang et al reported that D-dimer and prothrombin time were positively correlated with 28-day mortality of patients with COVID-19 [7]. Yao et al reported that D-dimer levels correlate with disease severity and are a reliable prognostic marker for in-hospital mortality in patients admitted for COVID-19 [8]
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