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The effect of coagulation factors in 2019 novel coronavirus patients: A systematic review and meta-analysis

Guiling Xiang1, Shengyu Hao, Cuiping Fu

  • 1Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.

Medicine
|February 20, 2021
PubMed

Insights

Coagulation dysfunction is linked to severe COVID-19 and higher mortality. Monitoring coagulation markers like D-dimer is crucial for managing severe cases and preventing complications.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The association between coagulation dysfunction and severe Coronavirus Disease 2019 (COVID-19) remains unclear.
  • Existing studies present inconsistent findings regarding the role of coagulopathy in COVID-19 patients.

Purpose of the Study:

  • To investigate the impact of coagulation dysfunction on COVID-19 severity.
  • To explore the relationship between coagulopathy and mortality in COVID-19 patients.

Main Methods:

  • A systematic literature search was conducted across PubMed, Cochrane, and Embase databases (December 2019 - April 2020).
  • Meta-analysis of observational studies following MOOSE guidelines was performed.
  • Data on coagulation parameters (Platelets, PT, APTT, fibrin, D-dimer), dysfunction prevalence, and mortality were extracted and analyzed using meta-regression.

Main Results:

  • Sixteen studies with 2,139 COVID-19 patients were included.
  • Severe COVID-19 cases showed significantly higher D-dimer, PT, and fibrin levels, and more frequent coagulation dysfunction.
  • Coagulopathy was associated with a substantially higher mortality risk (RR 10.86) and increased prevalence of Acute Respiratory Distress Syndrome (ARDS).

Conclusions:

  • Coagulation dysfunction is associated with increased COVID-19 severity and mortality.
  • Elevated PT, fibrin, and D-dimer levels may indicate disease progression and are linked to non-survival.
  • Effective monitoring of coagulation function is essential for managing severe COVID-19 and preventing related coagulopathy, despite evidence quality limitations.
Abstract

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