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Evaluation of coagulation parameters: Coronavirus disease 2019 (COVID-19) between survivors and nonsurvivors
Mehmet Ozdin1, Erdem Cokluk1,2, Selçuk Yaylaci3
1Sakarya University Education and Research Hospital, Medical Biochemistry Laboratory - Sakarya, Turkey.
Insights
Elevated D-dimer, prothrombin time, and international normalized ratio in COVID-19 patients indicate a higher risk of mortality. Close monitoring of these coagulation parameters is crucial for patient outcomes.
Area of Science:
- Hematology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is associated with significant morbidity and mortality.
- Coagulation abnormalities are frequently observed in COVID-19 patients.
- Understanding the relationship between coagulation parameters and patient outcomes is vital for effective management.
Purpose of the Study:
- To investigate and compare coagulation parameters in COVID-19 patients with different mortality outcomes.
- To identify specific coagulation markers associated with increased mortality risk in COVID-19.
Main Methods:
- Retrospective analysis of 511 COVID-19 patients (31 deceased, 480 recovered).
- Comparison of coagulation parameters including D-dimer, prothrombin time, and international normalized ratio between survivor and non-survivor groups.
- Statistical analysis using SPSS, including tests for normal distribution and significance.
Main Results:
- Older age was significantly associated with mortality (p=0.007).
- Non-survivors showed significantly higher median levels of D-dimer (p=0.005), prothrombin time (p=0.014), international normalized ratio (p=0.028), and neutrophils (p=0.001).
- Non-survivors had significantly lower median lymphocyte counts (p=0.037).
Conclusions:
- Increased D-dimer, prothrombin time, and international normalized ratio are significantly associated with mortality in COVID-19 patients.
- These coagulation parameters are critical indicators for monitoring disease severity and predicting outcomes.
- Close monitoring of these markers is recommended for improved patient care and management strategies.
Objective:
This study aims to investigate and compare the coagulation parameters of coronavirus disease 2019 (COVID-19) patients with mortal and nonmortal conditions.
Methods:
In this study, 511 patients diagnosed with COVID-19 were included. Information about 31 deceased and 480 recovered COVID-19 patients was obtained from the hospital information management system and analyzed retrospectively. Whether there was a correlation between coagulation parameters between the mortal and nonmortal patients was analyzed. Descriptive analyses on general characteristics of the study population were performed. Visual (probability plots and histograms) and analytical methods (Kolmogorov-Smirnov and Shapiro-Wilk test) were used to test the normal distribution. Analyses were performed using the SPSS statistical software package.
Results:
Out of 511 patients, 219 (42.9%) were females and 292 (57.1%) were males. There was no statistically significant difference between males and females in terms of mortality (p=0.521). In total, the median age was 67 (22). The median age was 74 (13) in the nonsurvivor group and 67 (22) in the survivor group, and the difference was statistically significant (p=0.007). The D-dimer, prothrombin time, international normalized ratio, neutrophil, and lymphocyte median age values with p-values, in the recovered and deceased patient groups were: 1070 (2129), 1990 (7513) μg FEU/L, p=0.005; 12.6 (2.10), 13.3 (2.1), p=0.014; 1.17 (0.21), 1.22 (0.19), p=0.028; 5.51 (6.15), 8.54 (7.05), p=0.001; and 0.99 (0.96), 0.64 (0.84), p=0.037, respectively, with statistically significant differences.
Conclusions:
As a result of this study, D-dimer, prothrombin time, and international normalized ratio increase were found to be associated with mortality. These parameters need to be closely monitored during the patient follow-up.
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