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Assessment of COVID -19 associated coagulopathy and multiple hemostatic markers: a single center study in Egypt

Azza Abdelaal1, Ahmed Abu-Elfatth2, Lamees M Bakkar3

  • 1Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.

Infection
|September 22, 2022
PubMed

Insights

COVID-19 infection causes coagulopathy, impacting patient outcomes. Elevated von Willebrand factor (VWF) and D-dimer levels are key indicators of disease severity and thrombosis risk in these patients.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coagulopathy is a significant complication of coronavirus-19 (COVID-19) disease.
  • Egyptian patients with COVID-19 exhibit coagulopathy and altered hemostatic markers.
  • Assessing coagulation acute phase reactants is crucial for understanding COVID-19 outcomes.

Purpose of the Study:

  • To evaluate COVID-19-associated coagulopathy in Egyptian patients.
  • To assess multiple hemostatic markers, including Fibrinogen, D-dimer, Factor VIII, von Willebrand factor (VWF), Protein C, Protein S, Antithrombin III (ATIII), and Lupus anticoagulant (LA).
  • To determine the effect of these markers on patient outcomes and disease severity.

Main Methods:

  • Included 106 COVID-19 patients and 51 controls.
  • Confirmed COVID-19 infection using real-time PCR for viral RNA detection.
  • Analyzed coagulation profile, focusing on Fibrinogen, D-dimer, Factor VIII, VWF, Protein C, Protein S, ATIII, and LA (LA-1 screening, LA-2 confirmation).

Main Results:

  • Significantly elevated VWF, D-dimer, and LA (LA-1 and LA-2) in COVID-19 patients compared to controls.
  • Severe COVID-19 cases showed higher D-dimer, FVIII, VWF, and LA1-2.
  • ATIII demonstrated high diagnostic accuracy for predicting disease severity. Higher INR and VWF were observed in patients with thrombotic events. VWF > 257.7 predicted thrombosis with 83.3% sensitivity and specificity.

Conclusions:

  • COVID-19 patients are susceptible to coagulopathy, which is linked to poor outcomes.
  • D-dimer is valuable for diagnosis and severity assessment but not for thrombosis prediction.
  • Early screening and management of coagulopathy can improve patient outcomes.
Abstract

Keywords:
COVID-19CoagulopathyEgyptThrombosis

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