The Relationship Between COVID-19 Related Coagulopathy with Organ Damage and Prognosis

Abstract

Objective: Coagulopathy and thromboembolic complications are frequently seen in COVID-19. We aimed to evaluate the relationship of coagulopathy with organ dysfunction and mortality in COVID-19.
 Methods: COVID-19 patients requiring intensive care for treatment and follow-up were retrospectively analyzed. In the definition of coagulopathy, the International Society on Thrombosis and Hemostasis (ISTH) overt disseminated intravascular coagulation (DIC) scoring system was used. Patients were divided into three groups according to the ISTH scores as follows; patients with no coagulopathy (ISTH score 2) and mechanical ventilation requirement, acute kidney injury (AKI), acute hepatic injury (AHI) and mortality rates were compared between these groups.
 Results: One hundred fifty-five critically ill adult patients with COVID-19 were included in the study. An abnormal coagulation profile developed in 94 (60.6%) patients; of those, 56 (36.1%) patients had non-evident abnormal coagulation, and 38 (24.5%) had evident abnormal coagulation. While there was a significant difference between the groups regarding coagulopathy and development of AKI, requirement for mechanical ventilation, and mortality, no significant difference was found in AHI and length of stay in the intensive care unit. Both mortality and development of AKI increased in correlation with the severity of coagulopathy. ISTH score and development of AKI and AHI were risk factors for both mortality and mechanical ventilation requirement.
 Conclusion: COVID-19-related coagulopathy, as determined by the ISTH overt DIC scoring system, is a predictor of organ damage and mortality.