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Predictive Values of Coagulation Parameters to Monitor COVID-19 Patients
Murat Seyit1, Esin Avci2, Atakan Yilmaz1
1Pamukkale University, Medical Faculty, Department of Emergency Medicine, Denizli 20070, Turkey.
Insights
Elevated D-dimer, prothrombin time (PT), and international normalized ratio (INR) were observed in COVID-19 patients. However, these coagulation markers did not accurately distinguish between positive and negative SARS-CoV-2 results, suggesting their role in assessing disease severity.
Area of Science:
- Medical Research
- Infectious Diseases
- Hematology
Background:
- Coronavirus disease (COVID-19) is a global health concern.
- Coagulation abnormalities are frequently observed in COVID-19 patients.
- Understanding the role of coagulation parameters in COVID-19 severity is crucial.
Purpose of the Study:
- To investigate the relationship between coagulation parameters (D-dimer, PT, INR, APTT) and COVID-19 severity.
- To assess the utility of these parameters in differentiating between SARS-CoV-2 positive and negative individuals.
- To explore the role of coagulation markers in hospitalized COVID-19 patients, including ICU admissions.
Main Methods:
- Retrospective study conducted in an Emergency Department.
- Inclusion of 289 patients with upper respiratory tract infection symptoms.
- Laboratory tests included SARS-CoV-2 PCR, D-dimer, PT, APTT, and INR.
Main Results:
- 110 patients tested PCR positive for SARS-CoV-2.
- Elevated mean levels of D-dimer, PT, and INR were found in COVID-19 positive patients.
- These coagulation parameters did not accurately differentiate between SARS-CoV-2 positive and negative groups.
Conclusions:
- D-dimer, PT, and INR levels are elevated in COVID-19 patients.
- These markers are not sufficient to accurately diagnose SARS-CoV-2 infection.
- Coagulation parameters may be important for documenting the clinical severity of hospitalized COVID-19 patients.
Aims:
In this study, we aim to unravel the relationship between coagulation parameters together with D-dimer and the severity of coronavirus disease (COVID-19) during hospitalization as well as hospitalization in the intensive care unit (ICU).
Methods:
This retrospective study was conducted in the Emergency Department (ED) of Pamukkale University Hospital (Denizli, Turkey) between March 1 and April 30, 2020. SARS-CoV-2 polymerase chain reaction (PCR) tests and laboratory tests, including international normalized ratio (INR), prothrombin time (PT), D-dimer, and activated thromboplastin time (APTT), were requested from 289 people presenting to the ED with symptoms of upper respiratory tract infection (URTI), such as cough, fever, and sore throat.
Results:
While 110 patients turned out to be polymerase chain reaction (PCR) positive, 181 individuals were PCR negative. The mean D-dimer level of the patient group was 147 ng/ml DDU (min: 9, max: 2948), and their mean PT level was found as 12.8 seconds (min: 10.3, max: 34.7). Besides, the mean APTT was 31.25 seconds (min: 19, max: 46.9), and the mean INR level was calculated as 1.09 (min: 0.88, max: 2.93). 35 of the patients were not hospitalized, while 43 were admitted to the Infectious Diseases, 20 to the Chest Diseases, and 12 to the ICU.
Conclusions:
It can be concluded from our findings that D-dimer, PT, and INR levels remained elevated in the COVID-19-diagnosed patients, but these parameters were unable to discriminate accurately between the patients with positive and negative SARS-CoV-2 results. Our findings also suggest that coagulation parameters might occupy a critical role in documenting clinical severity in patients with COVID-19 infection and requiring hospitalization.
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