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Research Paper|Volume 13, Issue 10|pp 13393—13404

Dynamic changes in coagulation parameters and correlation with disease severity and mortality in patients with COVID-19

Wei Xu1, Ling Fei1, Chen Lu Huang1, Wei Xia Li2, Xu Dong Xie1, Qiang Li1, Liang Chen1
  • 1Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
  • 2Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
* Equal contribution
Received: November 28, 2020Accepted: February 17, 2021Published: May 24, 2021
https://doi.org/10.18632/aging.203052

Copyright: © 2021 Xu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: This study aimed to describe the dynamic changes of coagulation parameters and evaluate the relationship between longitudinal coagulation parameters abnormalities and prognosis of COVID-19 patients.

Methods: We performed a retrospective study of 1131 COVID-19 patients. Longitudinal coagulation parameters and clinical outcomes were analyzed.

Results: Abnormal coagulation parameters were observed in patients with COVID-19, both at hospital admission (INR 2.3%, PT 7.9%, APTT 15.4%, TT 0.9%, FDP 2.3%, D-dimer 19.7%) and peak hospitalization (INR 4.8%, PT 13.4%, APTT 25.6%, TT 2.7%, FDP 10.4%, D-dimer 31.5%). Compared with non-severe patients with COVID-19, severe patients had a slightly higher INR, PT, APTT, whereas remarkably higher FDP and D-dimer (p < 0.05). On multivariate analysis, age > 60 years, male, obesity, comorbidity, abnormal D-dimer on hospital admission, and abnormal peak hospitalization PT, APTT, FDP and D-dimer were associated with COVID-19 severity. The extreme coagulation parameters abnormalities (PT > 16s, FDP > 50 ug/ml, and D-dimer > 5 ug/ml) were associated with a significantly higher mortality.

Conclusion: Longitudinal coagulation parameters abnormalities are common in patients with COVID-19, and associated with disease severity and mortality. Monitoring coagulation parameters is advisable to improve the management of patients with COVID-19.