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Hemostatic Changes in Patients with COVID-19: A Meta-Analysis with Meta-Regressions

Matteo Nicola Dario Di Minno1, Ilenia Calcaterra2, Roberta Lupoli3

  • 1Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy.

Journal of Clinical Medicine
|July 19, 2020
PubMed

Insights

Severe COVID-19 is linked to significant hemostatic changes, including higher D-Dimer and fibrinogen levels, and lower platelet counts. These findings highlight coagulopathy as a key complication in severe coronavirus disease 2019.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with coagulopathy, a significant factor in disease severity.
  • Understanding hemostatic alterations in COVID-19 is crucial for managing patient outcomes.

Purpose of the Study:

  • To conduct a meta-analysis assessing the relationship between COVID-19 severity and changes in key hemostatic parameters.
  • To compare hemostatic markers in severe versus mild COVID-19 cases and in non-survivors versus survivors.

Main Methods:

  • Systematic search and meta-analysis of studies reporting prothrombin time (PT), activated partial thromboplastin time (aPTT), D-Dimer, platelets (PLT), and fibrinogen levels.
  • Standardized Mean Difference (SMD) was calculated to quantify differences between patient groups.

Main Results:

  • Severe COVID-19 patients exhibited higher PT, D-Dimer, and fibrinogen levels, alongside lower platelet counts compared to mild cases.
  • Non-survivors of COVID-19 showed significantly higher PT and D-Dimer values, and lower platelet counts than survivors.
  • C-reactive protein levels correlated directly with differences in PT and fibrinogen.

Conclusions:

  • Significant alterations in hemostatic parameters are strongly associated with COVID-19 severity and mortality.
  • Further research is warranted to explore the prognostic value of these hemostatic markers in COVID-19 patients.
  • Investigating hemostatic parameters may aid in predicting severe outcomes and long-term complications of COVID-19.
Abstract

Keywords:
COVID-19SARS-CoV-2coagulationdisabilityhemostasisoutcomethrombosis

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