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Analysis of coagulation parameters in patients with COVID-19 in Shanghai, China
Ying Zou1, Hongying Guo1, Yuyi Zhang1
1Department of Severe hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Insights
Coagulation dysfunction is common in Coronavirus disease 2019 (COVID-19) patients, particularly severe cases. Elevated fibrinogen and D-dimer levels correlate with disease severity, but improve with recovery.
Area of Science:
- * Hematology
- * Infectious Diseases
- * Critical Care Medicine
Background:
- * Coronavirus disease 2019 (COVID-19) is a global health crisis with significant morbidity and mortality.
- * Coagulation abnormalities have been frequently reported in COVID-19 patients, but their precise characteristics and correlation with disease severity require further elucidation.
Purpose of the Study:
- * To investigate the characteristics of coagulation function in patients with COVID-19.
- * To evaluate the correlation between coagulation parameters and the severity of COVID-19.
- * To assess the changes in coagulation function during disease recovery.
Main Methods:
- * Retrospective analysis of clinical data from 303 patients diagnosed with COVID-19.
- * Comparison of coagulation function between mild and severe disease groups.
- * Evaluation of coagulation parameters including international normalized ratio, prothrombin time, activated partial thromboplastin time, fibrinogen, fibrinogen degradation products, and D-dimer.
Main Results:
- * Coagulation abnormalities were observed in 69.0% of hospitalized COVID-19 patients.
- * Severe COVID-19 cases exhibited significantly higher proportions of abnormal coagulation indicators (100% vs. 66.1%) compared to mild cases.
- * Elevated levels of international normalized ratio, prothrombin time, activated partial thromboplastin time, fibrinogen, fibrinogen degradation products, and D-dimer were significantly associated with severe disease.
- * Fibrinogen and activated partial thromboplastin time normalized as the disease resolved.
Conclusions:
- * Coagulation dysfunction is a prevalent complication in COVID-19 patients.
- * Elevated fibrinogen and D-dimer levels are key indicators of disease severity in COVID-19.
- * Coagulation parameters, particularly fibrinogen and activated partial thromboplastin time, show improvement with disease recovery.
Abstract:
To investigate the characteristic of coagulation function in 303 patients with Coronavirus disease 2019 (COVID-19), we evaluated the correlation between coagulation function and disease status. We retrospectively analyzed 303 patients diagnosed with COVID-19 and evaluated the clinical data of 240 patients who were discharged. The coagulation function of the two groups (mild and severe) was compared. Compared with the mild group, majority of patients in the severe group were male (76.9% vs. 49.8%) and elderly (median age 65 vs. 50), and the proportion with chronic underlying diseases was higher (73.1% vs. 36.1%). There were 209 abnormalities (69.0%) of coagulation parameters in 303 patients admitted to hospital. Comparison of various indexes of coagulation function between the two groups in admission, the proportion of abnormal coagulation indicators in the severe group was higher than that in the mild group (100% vs. 66.1%). The median coagulation parameters in the severe group were higher than those in the mild group: international normalized ratio (1.04 vs. 1.01), prothrombin time (13.8 vs. 13.4) seconds, activated partial thromboplastin time (43.2 vs. 39.2) seconds, fibrinogen (4.74 vs. 4.33) g/L, fibrinogen degradation products (2.61 vs. 0.99) µg/mL, and D-dimer (1.04 vs. 0.43) µg/mL, the differences were statistically significant (p < 0.05). Coagulation dysfunction is common in patients with COVID-19, especially fibrinogen and D-dimer elevation, and the degree of elevation is related to the severity of the disease. As the disease recovers, fibrinogen and activated partial thromboplastin time also return to normal.
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