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Status of Inflammatory and Coagulation Factors in COVID-19 and Its Relation with the Disease Severity
Atoosa Gharib1, Zahra Nematollahi2, Behrang Kazeminejad1
1Department of Pathology and Laboratory Medicine, Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Inflammatory and coagulation factors like fibrinogen, D-dimer, protein C, and protein S predict COVID-19 severity. Lower protein C levels were the strongest indicator for ICU admission, highlighting their prognostic value in severe disease.
Area of Science:
- Medical Research
- Infectious Diseases
- Hematology
Background:
- Inflammation exacerbates COVID-19, and thromboembolic events can occur post-recovery.
- Prognostic factors for COVID-19 severity remain debated.
- This study investigated inflammatory and coagulation markers for predicting disease severity.
Purpose of the Study:
- To evaluate the prognostic role of specific inflammatory and coagulation factors in predicting COVID-19 severity.
- To determine if these factors correlate with the need for intensive care unit (ICU) admission.
Main Methods:
- A cross-sectional study of 46 adult COVID-19 patients.
- Assessed coagulation profiles (D-dimer, protein S, protein C, fibrinogen) and inflammatory markers (interleukin-6).
- Measured serum levels using automated analyzers and ELISA techniques.
Main Results:
- 45.7% of patients required ICU admission.
- Significant differences in fibrinogen, D-dimer, protein C, and protein S levels were observed between ICU and non-ICU groups.
- Decreased protein C levels showed the highest predictive value for disease severity and ICU admission.
Conclusions:
- Fibrinogen, D-dimer, protein C, and protein S levels are confirmed predictors of severe COVID-19.
- These markers are crucial for identifying patients at risk of requiring ICU admission.
- Protein C levels are particularly significant in forecasting COVID-19 severity.
Background:
The role of activation of inflammatory processes in the exacerbation of COVID-19 disease has been fully confirmed. In addition, the occurrence of thromboembolic events in patients with COVID-19 is expected even long after recovery from the disease. However, which factors are essentially prognostic for this disease is still not theoretically agreed upon. What we did in the present study was to evaluate the prognostic role of some inflammatory and coagulation factors in predicting the severity of COVID-19 disease. In this study, the need for ICU admission was considered as a symbol of disease severity.
Materials And Methods:
Forty-six cases were studied in this cross-sectional study. Patients over 18 years of age with a definitive diagnosis of COVID-19 were assessed in terms of coagulation profiles and inflammatory and cytokine markers. Regarding laboratory data, serum levels of D-dimer, protein S, protein C, FDP, and fibrinogen were measured using an automated coagulation analyzer, and serum levels of interleukin-6 were measured using the ELISA technique.
Results:
In total, 21 patients (45.7%) were admitted to the ICU due to the severity of the disease. In comparing inflammatory and coagulation factors between the two groups of patients, with and without ICU admission, a significant difference was revealed between fibrinogen (P=0.023), D-dimer (P=0.047), protein C (P=0.001), and protein S level (P=0.014). The decrease in protein C level had the highest value for predicting the severity of the disease and therefore the need for ICU admission.
Conclusion:
Among various inflammatory and coagulation factors, the role of fibrinogen, D-dimer, protein C, and protein S in predicting the severe form of COVID-19 and the patient's need for ICU admission was confirmed.
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