Plasma haemostatic levels in COVID-19 patients and healthy controls: A comparative study at Two tertiary Hospitals in Zambia

Abstract

COVID-19 is a novel coronavirus disease that has caused a global pandemic with millions of confirmed cases and deaths worldwide. One of the major complications associated with COVID-19 is the development of a hypercoagulable state, leading to thrombotic events such as venous thromboembolism, pulmonary embolism, stroke, and myocardial infarction. The pathophysiology of COVID-19-associated coagulopathy involves a complex interplay between viral infection, host immune response, endothelial dysfunction, and inflammatory cytokine storm. The main objective of this study was to evaluate Plasma Haemostatic Levels in COVID-19 Patients and Healthy Controls and its association with COVID-19 severity levels. This was a mixed-methods research project that employed cross-sectional and case-control study designs. The study population consisted of SARS-CoV-2 positive patients at Ndola Teaching Hospital (NTH) and Levy Mwanawasa University Teaching Hospital (LMUTH). The laboratory tests included the assessment of haemostatic profiles in COVID-19 patients compared to control subjects. Additionally, this study explored the use of haemostatic profiles in classifying COVID-19 severity in relation to the clinical methods currently in use. Data analysis was performed using SPSS version 21. Our study observed elevated plasma levels of haemostatic profiles such as D-dimer, Von Willebrand Factor (VWF), VWF/ADAMTS13 ratio, Factor VIII, Plasminogen Activator Inhibitor (PAI), and Soluble P-selectin in COVID-19 patients compared to the control group. Additionally, COVID-19 patients exhibited a higher prevalence of hypercoagulability (57.2%) compared to control participants (3%). The study also found that the frequency of coagulability increased with COVID-19 severity. Furthermore, statistically significant differences in mean haemostatic plasma concentration were observed in relation to COVID-19 disease severity. In conclusion, our study found that COVID-19 patients exhibited elevated haemostatic parameters compared to healthy controls. These parameters were observed to correlate with COVID-19 severity levels. The study provides valuable insights into the haemostatic mechanisms of COVID-19 and identifies potential biomarkers for hypercoagulability. These findings may have implications for the diagnosis, prognosis, and management of COVID-19 patients. Clinicians can utilize this information to identify patients with a poor prognosis and assess disease severity, enabling early intervention.