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Coagulation dysfunction is associated with severity of COVID-19: A meta-analysis
Jieyun Zhu1, Jielong Pang1, Pan Ji1
1Department of Emergency Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China.
Journal of Medical Virology
|July 25, 2020
Summary
Severe COVID-19 patients commonly exhibit blood coagulation dysfunction, including lower platelet counts and higher D-dimer and fibrinogen levels. These coagulation abnormalities are linked to disease severity and mortality in COVID-19.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has been associated with various clinical manifestations, including significant alterations in blood coagulation.
- Understanding these coagulation changes is crucial for managing severe cases and improving patient outcomes.
- Previous studies have suggested a link between COVID-19 severity and hemostatic abnormalities.
Purpose of the Study:
- To systematically analyze the blood coagulation features of coronavirus disease 2019 (COVID-19) patients.
- To provide a reference for clinical practice regarding COVID-19-associated coagulation disorders.
- To correlate coagulation parameters with disease severity and mortality.
Main Methods:
- A systematic electronic literature search was conducted across multiple databases (PubMed, EMbase, Web of Science, Scopus, CNKI, WanFang Data, VIP) for studies published between January 1, 2020, and April 21, 2020.
- Thirty-four studies involving 6492 COVID-19 patients were included.
- Meta-analysis was performed using Stata 12.0 software to assess differences in coagulation parameters between severe and non-severe cases, and between deceased and survived patients.
Main Results:
- Severe COVID-19 patients showed significantly lower platelet counts, shorter activated partial thromboplastin time, higher D-dimer and fibrinogen levels, and longer prothrombin time (PT) compared to non-severe cases.
- Patients who died from COVID-19 had significantly higher D-dimer levels, longer PT, and lower platelet counts than survivors.
- Coagulation dysfunction is a common finding in severe COVID-19 and is associated with increased disease severity.
Conclusions:
- Blood coagulation dysfunction is prevalent in severe COVID-19 patients.
- Specific coagulation parameters, such as platelet count, D-dimer, fibrinogen, and PT, are significantly altered in severe disease and correlate with mortality.
- These findings underscore the importance of monitoring coagulation status in COVID-19 patients for clinical management.
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