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Characteristics of coagulation alteration in patients with COVID-19

Hong-Chun Luo1, Cheng-Yan You2,3,4, Si-Wei Lu2,3,4

  • 1Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.

Annals of Hematology
|October 20, 2020
PubMed

Insights

Abnormal blood coagulation is common in critically ill COVID-19 patients. Prothrombin time activity (PT-act) below 75% at admission independently predicts in-hospital death, offering a key prognostic marker.

Area of Science:

  • Hematology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Abnormal blood coagulation is a significant factor impacting prognosis in critically ill patients.
  • Coronavirus disease 2019 (COVID-19) is frequently associated with coagulopathy.

Purpose of the Study:

  • To investigate the implications of altered blood coagulation parameters in COVID-19 patients.
  • To identify predictors of in-hospital mortality in COVID-19 patients.

Main Methods:

  • Retrospective review of 85 COVID-19 patients admitted between February 4-16, 2020.
  • Analysis of admission coagulation markers including prothrombin time (PT), international normalized ratio (INR), D-dimer, fibrin/fibrinogen degradation products (FDP), and prothrombin time activity (PT-act).
  • Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis to assess mortality prediction.

Main Results:

  • Non-survivors had significantly higher admission PT, INR, D-dimer, and FDP levels compared to survivors.
  • Non-survivors exhibited lower PT-act and PaO2/FiO2 ratios.
  • PT-act < 75% at admission was independently associated with increased in-hospital mortality.
  • PT-act, D-dimer, and FDP demonstrated significant predictive value for mortality, with PT-act showing a trend towards superior performance.

Conclusions:

  • COVID-19 is characterized by abnormal coagulation, impacting patient outcomes.
  • Admission PT-act is a valuable independent predictor of mortality in COVID-19 patients.
  • Coagulation parameters, including PT-act, D-dimer, and FDP, can predict mortality and may improve with treatment.

Keywords:
Blood coagulationCOVID-19D-DimerDeathProthrombin time activity

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