Association of coagulation disturbances with severity of COVID-19: a longitudinal study.

Abstract

OBJECTIVES:

Coagulation dysfunction is an evident factor in the clinical diagnosis and treatment of patients with coronavirus disease 2019 (COVID-19), appearing even in COVID-19 patients with normal inflammation indices. Therefore, this study aimed to analyze the characteristics of coagulation function indices in COVID-19 patients to investigate possible mechanisms through the comparison of non-severe and severe COVID-19 patients.

METHODS:

We included 143 patients whose clinical characteristics, coagulation function, and other indices such as inflammatory factors were collected and compared based on disease severity.

RESULTS:

Activated partial thromboplastin time (APTT), D-dimer, and fibrinogen levels were evidently higher in the severe group than in the non-severe group. Among non-severe COVID-19 patients, the aforementioned indicators depicted increasing trends, but the fibrinogen level alone was higher than normal. However, in severe COVID-19 patients, values of all three indices were higher than normal. In severe COVID-19 patients, fibrinogen and D-dimer were correlated with several inflammation indices during the early stage of the disease. However, no correlation between fibrinogen and inflammatory factors was observed in non-severe COVID-19 patients at any time point.

DISCUSSION:

Results revealed that the hypercoagulability tendency of severe COVID-19 patients was more evident. The relationship between coagulation function and inflammatory factors showed that changes in coagulation function in severe COVID-19 patients may be related to abnormal increase in inflammatory factors at an early stage; however, in non-severe COVID-19 patients, there might be other factors leading to abnormal coagulation.

CONCLUSION:

Inflammatory factors were not the only cause of abnormal coagulation function in COVID-19 patients.

• Authors: Huimin Lu, Ming Chen, Shaoqiu Tang, Wenkui Yu
• Journal: Hematology (Amsterdam, Netherlands) (Hematology) Vol. 26 Issue 1 Pg. 656-662 (Dec 2021) ISSN: 1607-8454 [Electronic] England
• PMID: 34493174 (Publication Type: Journal Article)

Chemical References

• Fibrin Fibrinogen Degradation Products
• fibrin fragment D
• Fibrinogen

Topics

• Adult
• Aged
• Blood Coagulation
• COVID-19 (blood, complications)
• Disseminated Intravascular Coagulation (blood, etiology)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Fibrinogen (analysis)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Partial Thromboplastin Time
• Severity of Illness Index
• Thrombophilia (blood, etiology)