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COVID-19 coagulopathy: An in-depth analysis of the coagulation system

Reyes María Martín-Rojas1, Gloria Pérez-Rus1,2, Valeria Estefania Delgado-Pinos1

  • 1Department of Hematology, University General Hospital Gregorio Marañon, Madrid, Spain.

European Journal of Haematology
|August 5, 2020
PubMed

Insights

COVID-19 is linked to coagulopathy and poor prognosis, but factor consumption typical of disseminated intravascular coagulation (DIC) was not observed. Elevated D-dimer indicates higher risk in these patients.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • COVID-19 infection is associated with abnormal coagulation parameters.
  • The exact mechanism of COVID-19 coagulopathy is unclear, with disseminated intravascular coagulation (DIC) proposed.
  • Understanding COVID-19's impact on coagulation is crucial for patient management.

Purpose of the Study:

  • To analyze coagulation parameters in COVID-19 patients.
  • To investigate potential coagulation factor consumption.
  • To identify prognostic biomarkers for COVID-19 disease severity.

Main Methods:

  • Collected blood samples from 206 hospitalized COVID-19 pneumonia patients.
  • Performed coagulation tests, including factor quantification and inhibitor protein levels.
  • Correlated laboratory findings with clinical data and patient outcomes.

Main Results:

  • Elevated D-dimer levels were observed (median 450 ng/mL).
  • Free protein S levels were decreased, and Factor VIII showed an increasing trend.
  • No correlation between abnormal coagulation and thrombosis was found, except for higher D-dimer (HR 1.99).

Conclusions:

  • COVID-19 is associated with coagulopathy that correlates with poor prognosis.
  • Evidence of coagulation factor consumption, characteristic of DIC, was not demonstrated.
  • Elevated D-dimer may serve as a prognostic indicator in COVID-19 patients.
Abstract

Keywords:
COVID-19D-dimerSARS-CoV-2 infectioncoagulation factorscoagulopathy

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