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The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19

Year 2022, Volume: 39 Issue: 1, 232 - 236, 01.01.2022

Abstract

Covid-19 is a viral infection have a high pathogencitity and contagiousness that primarily targets the human respiratory system and leading to a global pandemic. Abnormal coagulation parameters are quite common in Covid-19 patients. In our study, we aimed to evaluate the relationship between coagulation function with disease severity and survival status in Covid-19 patients and the prognostic, predictive value of these parameters. Results of prothrombin time (PT), activated partial thromboplastin time (aPTT), Fibrinogen, and D-Dimer parameters at admission time of 76 Covid-19 negative healthy control with 188 confirmed Covid-19 patients, as well as death events were retrospectively analyzed. Compared with the healthy control group, higher levels of D-Dimer, PT, aPTT, fibrinogen, and CRP (p <0.001 for each) were present during admission in Covid-19 patients. The non-survivor group had higher levels of PT, D-Dimer, and CRP (p <0.001 for each) and aPTT (p =0.004), fibrinogen (p =0.019) compared to the survivor group. 28 (14.89%) of 188 Covid-19 patients lost their lives. Analysis of the ROC curve revealed that D-Dimer, Fibrinogen, PT, aPTT, and CRP had high diagnostic value in distinguishing Covid-19 patients from healthy control group, the critical group from the severe group, and non-survivors from survivors. This study shows that coagulation function is significantly impaired in patients with Covid-19 infection compared to normal patients, and as particularly marked high levels of D-Dimer, PT, aPTT, fibrinogen, and CRP are common. This condition is associated with disease severity and increased mortality. Coagulation parameters are an effective and useful marker for assessing prognosis and for the management of Covid-19 patients.

Thanks

ACKNOWLEDGMENTS I would like to thank Dr. Yeliz Kaşko Arıcı from the Department of Biostatistics of the Faculty of Medicine of Ordu University for her support in the field of Statistics

References

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  • 6. Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020; 15(5):700-704. doi: 10.1016/j.jtho.2020.02.010.
  • 7. Ding YQ, Bian XW. Analysis of coronavirus disease-19 (covid-19) based on SARS autopsy. Chin J Pathol. 2020; 49(4):291-293. doi: 10.3760/cma.j.cn112151-20200211-00114.
  • 8. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020; 5;153(6):725-733. doi: 10.1093/ajcp/aqaa062.
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  • 12. https:// www.covid19.saglik.gov.tr/ 2020
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  • 18. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020; 18(6):1324-1329. doi: 10.1111/jth.14859.
  • 19. Harenberg J, Favaloro E. COVID-19: progression of disease and intravascular coagulation - present status and future perspectives. Clin Chem Lab Med. 2020; 25;58(7):1029-1036. doi: 10.1515/cclm-2020-0502.
  • 20. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.
  • 21. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 10223:497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 22 Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in Covid-19. J Thromb Haemost. 2020; 18(5):1023-1026. doi: 10.1111/jth.14810.
  • 23. Luo L, Xu M, Du M, Kou H, Liao D, Cheng Z, et al. Early coagulation tests predict risk stratification and prognosis of COVID-19. Aging (Albany NY). 2020; 12(16): 15918–15937. doi: 10.18632/aging.103581.
  • Bermejo-Martin JF, Martín-Fernandez M, López-Mestanza C, Duque P, Almansa R. Shared Features of Endothelial Dysfunction between Sepsis and Its Preceding Risk Factors (Aging and Chronic Disease). J Clin Med. 2018; 7(11): 400. doi: 10.3390/jcm7110400.
  • 25. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020; 18(5):1094-1099. doi: 10.1111/jth.14817.
  • 26. Song JC, Wang G, Zhang W, Zhang Y, Li WQ, Zhou Z. Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19. Mil Med Res. 2020; 1:19. doi: 10.1186/s40779-020-00247-7.
  • 27. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Chin J Epidemiol. 2020; 2:145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.
  • 28. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3.
  • 29. Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med. 2020; 25;58(7):1070-1076. doi: 10.1515/cclm-2020-0285.
  • 30. Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019 [COVID-19]: a pooled analysis. Thromb Haemost 2020; 120(5):876-878. doi: 10.1055/s-0040-1709650.
  • 31. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; (18)382::1708-1720. doi: 10.1056/NEJMoa2002032
  • 32. Tanaka T, Narazaki M, Kishimoto T. Immunotherapeutic implications of IL-6 blockade for cytokine storm. Immunotherapy. 2016; 8(8):959-70. doi: 10.2217/imt-2016-0020.
  • 33. Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020; 92(7):791-796. doi: 10.1002/jmv.25770.
  • 34. Gralinski LE, Bankhead A 3rd, Jeng S, Menachery VD, Proll S, Belisle SE, et al. Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury. MBio. 2013; 6;4(4): e00271-13. doi: 10.1128/mBio.00271-13.
  • 35. Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, et al. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020; 146(1):89-100. doi: 10.1016/j.jaci.2020.05.003.
Year 2022, Volume: 39 Issue: 1, 232 - 236, 01.01.2022

Abstract

References

  • 1. Rai P, Kumar BK, Deekshit VK, Karunasagar I, Karunasagar I. Detection technologies and recent developments in the diagnosis of COVID-19 infection. Appl Microbiol Biotechnol. 2021;105(2):441-455. doi:10.1007/s00253-020-11061-5
  • 2. World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Jan 30, 2020. https://bit.ly/2zc56Vk (accessed May 2020).
  • 3. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-1242. doi: 10.1001/jama.2020.2648.
  • 4. Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: a retrospective observational study. Am J Respir Crit Care Med. 2020; 201(11):1372-1379. doi: 10.1164/rccm.202003-0543OC.
  • 5. Xiong Y, Liu Y, Cao L, Wang D, Guo M, Jiang A, et al. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect. 2020; 9(1):761-770. doi: 10.1080/22221751.2020.1747363.
  • 6. Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020; 15(5):700-704. doi: 10.1016/j.jtho.2020.02.010.
  • 7. Ding YQ, Bian XW. Analysis of coronavirus disease-19 (covid-19) based on SARS autopsy. Chin J Pathol. 2020; 49(4):291-293. doi: 10.3760/cma.j.cn112151-20200211-00114.
  • 8. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol. 2020; 5;153(6):725-733. doi: 10.1093/ajcp/aqaa062.
  • 9. Zhang L, Long Y, Xiao H, Yang J, Toulon P, Zhang Z. Use of D-dimer in oral anticoagulation therapy. International journal of laboratory hematology. 2018; 40: 503-7. 10.1111/ijlh.12864.
  • 10. Tang N, Li D, Wang X, Sun Z. Abnormal Coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(4):844-847. doi: 10.1111/jth.14768.
  • 11. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical char-acteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a de-scriptive study. Lancet. 2020; 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7.
  • 12. https:// www.covid19.saglik.gov.tr/ 2020
  • 13. Han H, Yang L, Liu R, Liu F, Wu KL, Li J, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med. 2020; 25;58(7):1116-1120. doi: 10.1515/cclm-2020-0188.
  • 14. Vaninov N. In the eye of the COVID-19 cytokine storm. Nat Rev Immunol. 2020; 20(5):277. doi: 10.1038/s41577-020-0305-6.
  • 15. Zou Y, Guo H, Zhang Y, Zhang Z, Liu Y, Wang J, et al. Analysis of coagulation parameters in patients with COVID-19 in Shanghai, China. Biosci Trends. 2020; 14(4):285-289. doi: 10.5582/bst.2020.03086.
  • 16. Sathler PC. Hemostatic abnormalities in COVID-19: A guided review. An Acad Bras Cienc. 2020; 92(4): e20200834. Doi: 10.1590/0001-3765202020200834.
  • 17. Fogarty H, Townsend L, Cheallaigh CN, Bergin C, Martin-Loeches I, Browne P, et al. COVID19 coagulopathy in Caucasian patients. Br J Haematol. 2020; 189(6):1044-1049. doi: 10.1111/bjh.16749
  • 18. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020; 18(6):1324-1329. doi: 10.1111/jth.14859.
  • 19. Harenberg J, Favaloro E. COVID-19: progression of disease and intravascular coagulation - present status and future perspectives. Clin Chem Lab Med. 2020; 25;58(7):1029-1036. doi: 10.1515/cclm-2020-0502.
  • 20. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.
  • 21. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 10223:497-506. doi: 10.1016/S0140-6736(20)30183-5.
  • 22 Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in Covid-19. J Thromb Haemost. 2020; 18(5):1023-1026. doi: 10.1111/jth.14810.
  • 23. Luo L, Xu M, Du M, Kou H, Liao D, Cheng Z, et al. Early coagulation tests predict risk stratification and prognosis of COVID-19. Aging (Albany NY). 2020; 12(16): 15918–15937. doi: 10.18632/aging.103581.
  • Bermejo-Martin JF, Martín-Fernandez M, López-Mestanza C, Duque P, Almansa R. Shared Features of Endothelial Dysfunction between Sepsis and Its Preceding Risk Factors (Aging and Chronic Disease). J Clin Med. 2018; 7(11): 400. doi: 10.3390/jcm7110400.
  • 25. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020; 18(5):1094-1099. doi: 10.1111/jth.14817.
  • 26. Song JC, Wang G, Zhang W, Zhang Y, Li WQ, Zhou Z. Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19. Mil Med Res. 2020; 1:19. doi: 10.1186/s40779-020-00247-7.
  • 27. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Chin J Epidemiol. 2020; 2:145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.
  • 28. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3.
  • 29. Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clin Chem Lab Med. 2020; 25;58(7):1070-1076. doi: 10.1515/cclm-2020-0285.
  • 30. Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019 [COVID-19]: a pooled analysis. Thromb Haemost 2020; 120(5):876-878. doi: 10.1055/s-0040-1709650.
  • 31. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; (18)382::1708-1720. doi: 10.1056/NEJMoa2002032
  • 32. Tanaka T, Narazaki M, Kishimoto T. Immunotherapeutic implications of IL-6 blockade for cytokine storm. Immunotherapy. 2016; 8(8):959-70. doi: 10.2217/imt-2016-0020.
  • 33. Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020; 92(7):791-796. doi: 10.1002/jmv.25770.
  • 34. Gralinski LE, Bankhead A 3rd, Jeng S, Menachery VD, Proll S, Belisle SE, et al. Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury. MBio. 2013; 6;4(4): e00271-13. doi: 10.1128/mBio.00271-13.
  • 35. Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, et al. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020; 146(1):89-100. doi: 10.1016/j.jaci.2020.05.003.
There are 35 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Gülsen Şener 0000-0002-2006-2175

Early Pub Date January 3, 2022
Publication Date January 1, 2022
Submission Date August 3, 2021
Acceptance Date December 29, 2021
Published in Issue Year 2022 Volume: 39 Issue: 1

Cite

APA Şener, G. (2022). The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19. Journal of Experimental and Clinical Medicine, 39(1), 232-236.
AMA Şener G. The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19. J. Exp. Clin. Med. January 2022;39(1):232-236.
Chicago Şener, Gülsen. “The Effectiveness of Coagulation Parameters in Classifying Patients and Predicting Mortality in Covid-19”. Journal of Experimental and Clinical Medicine 39, no. 1 (January 2022): 232-36.
EndNote Şener G (January 1, 2022) The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19. Journal of Experimental and Clinical Medicine 39 1 232–236.
IEEE G. Şener, “The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19”, J. Exp. Clin. Med., vol. 39, no. 1, pp. 232–236, 2022.
ISNAD Şener, Gülsen. “The Effectiveness of Coagulation Parameters in Classifying Patients and Predicting Mortality in Covid-19”. Journal of Experimental and Clinical Medicine 39/1 (January 2022), 232-236.
JAMA Şener G. The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19. J. Exp. Clin. Med. 2022;39:232–236.
MLA Şener, Gülsen. “The Effectiveness of Coagulation Parameters in Classifying Patients and Predicting Mortality in Covid-19”. Journal of Experimental and Clinical Medicine, vol. 39, no. 1, 2022, pp. 232-6.
Vancouver Şener G. The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19. J. Exp. Clin. Med. 2022;39(1):232-6.