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Early coagulation tests predict risk stratification and prognosis of COVID-19

Lili Luo1,2, Min Xu1,2, Mengyi Du1,2

  • 1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Aging
|August 30, 2020
PubMed

Insights

Early coagulation tests can help predict COVID-19 severity. Prolonged prothrombin time and elevated D-dimer levels indicate a higher risk of intensive care unit (ICU) admission or death in patients with Coronavirus Disease 2019 (COVID-19).

Area of Science:

  • Infectious Diseases
  • Hematology
  • Critical Care Medicine

Background:

  • The Coronavirus Disease 2019 (COVID-19) pandemic presents challenges in understanding disease progression.
  • The link between coagulation disorders and COVID-19 severity remains unclear.
  • Early identification of prognostic markers is crucial for managing COVID-19 patients.

Purpose of the Study:

  • To investigate the predictive value of early coagulation tests for risk stratification in COVID-19 patients.
  • To assess the relationship between coagulation parameters and disease severity.
  • To determine the prognostic implications of coagulation abnormalities in COVID-19.

Main Methods:

  • A systematic literature search was conducted across PubMed, Web of Science, Cochrane Library, and Scopus up to March 24, 2020.
  • Twenty-four relevant studies were included in the meta-analysis.
  • Pooled standard mean differences (SMD) of coagulation parameters were calculated to assess correlations with disease severity and composite endpoints (ICU admission or death).

Main Results:

  • Elevated D-dimer levels correlated positively with COVID-19 disease severity (SMD 0.787).
  • Prolonged prothrombin time (PT) was associated with an increased risk of ICU admission and death (SMD 1.338).
  • Platelet count showed no significant relationship with disease severity or composite endpoints. Increased fibrin degradation products (FDP) and decreased antithrombin may indicate worsening disease.

Conclusions:

  • Early coagulation tests, including D-dimer and PT, are valuable for assessing COVID-19 severity and prognosis.
  • Dynamic monitoring of coagulation parameters can aid in timely therapeutic interventions.
  • Recognizing and managing coagulation disorders in COVID-19 patients is essential for improving outcomes.

Keywords:
COVID-19blood coagulation disordersmeta-analysisprognosisrisk

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