Critical biomarkers in the battle against COVID-19: unveiling thrombotic risks and predictive indicators in Syrian...

The global COVID-19 pandemic has caused a significant number of fatalities, placing immense strain on healthcare systems worldwide. It is imperative to comprehend the clinical parameters that influence patient outcomes, especially in resource-limited settings such as Syria. This study specifically focuses on thrombotic laboratory parameters and their role in predicting the severity and mortality of COVID-19 patients.

This prospective, multicenter study was conducted in Al-Razi Hospital and the University Cardiac Surgery Hospital in Aleppo, Syria. It included 60 adult patients diagnosed with SARS-CoV-2 using real-time quantitative polymerase chain reaction, admitted between November 2021 and March 2022. Demographic data, clinical characteristics, and laboratory parameters, including D-dimer, international normalized ratio, fibrinogen, and complete blood count, were collected and analyzed. Statistical analyses were performed using SPSS version 27.

Among the 60 patients (42 males, 18 females), the mean age was 63.87 years. Key findings revealed a high mortality rate of 50% among hospitalized patients. Elevated D-dimer levels at admission were significantly associated with increased mortality (P < 0.001), with a threshold value of 1550 ng/ml predicting death with 80% sensitivity and 85% accuracy. Additionally, age over 61.5 years and preexisting cardiovascular diseases also significantly influenced survival outcomes. Dyspnea was the only symptom significantly associated with poor survival (P = 0.004). Also, a total of nine patients (15%) experienced thrombosis-related incidents, which included myocardial infarction (five patients), symptomatic venous thromboembolism (two patients), stroke (one patient), and disseminated intravascular coagulation (one patient); thrombotic events (both arterial and venous) exhibited significant associations with several factors; total death (P = 0.006), post-discharge mortality (P < 0.001) and cardiovascular disease history (P = 0.034).

Monitoring thrombotic parameters such as D-dimer levels is crucial in predicting the severity and mortality of COVID-19 in hospitalized patients. These findings highlight the need for targeted therapeutic strategies to improve patient outcomes, particularly in resource-constrained environments like Syria.