Blood coagulation parameter abnormalities in hospitalized patients with confirmed COVID-19 in Ethiopia

Abstract

Background Coagulopathy and thromboembolic events are among the complications of Corona Virus disease 2019 (COVID-19). Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity. The aim of this study was to analyze coagulation profiles of hospitalized COVID-19 patients in Addis Ababa, Ethiopia. Methods This prospective cross-sectional study was conducted among 455 Covid-19 patients admitted at Millennium COVID-19 care and treatment center, Addis Ababa, Ethiopia from July 1- October 23, 2020. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and International normalized ratio (INR) were determined on HUMACLOT DUE PLUS® coagulation analyzer (Wiesbaden, Germany). In all statistical analysis of results, p<0.05 was defined as statistically significant. Result A prolonged prothrombin time was found in 46.8% of study participants with COVID-19 and a prolonged prothrombin time and elevated INR in 53.3% of study subjects with severe and 51% of critically COVID patients. Thrombocytopenia was detected in 22.1% of COVID-19 patients. 50.5% and 51.3% of COVID-19 patients older than 55 years had thrombocytopenia and prolonged APTT respectively. Conclusion In this study, prolonged prothrombin time and elevated INR were detected in more than 50% of severe and critical COVID-19 patients. Thrombocytopenia and prolonged APTT were dominant in COVID-19 patients older than 55 years. Thus, we recommend emphasis to be given for monitoring of platelet count, PT, APTT and INR in hospitalized and admitted COVID-19 patients.

Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania

“…In our study, aPTT was the parameter with the highest prediction of mortality in COVID-19 patients, with an AUC of 0.753 and also had a good sensitivity and the highest specificity (92%). In addition, consistent with our findings, several studies showed that aPTT was significantly longer in non-surviving COVID-19 patients [ 15 , 16 , 17 ]. The second most significant parameter in the mortality of COVID-19 patients from our study is D-dimer, which showed a good performance with an AUC of 0.751.…”

COVID-19 in Pediatrics: Demographic, Clinical, Laboratory, and Radiological Characteristics of Infected Patients With SARS-CoV-2

“…Prolonged PT and elevated PT/INR (international normalized ratio) were detected significantly more often in deceased and ICU admitted children. In line with previous studies in adults and children (40,41), the correlation between coagulation irregularities and the disease severity was confirmed, indicating that liver dysfunction can be used as a marker for predicting the severity of COVID-19 in children (42). In this study, a tendency for increased severity was seen among cases with elevated AST, similar to results from a meta-analysis (43).…”

Splenic Infarction in a COVID-19 Patient without Respiratory Symptoms

“…Although the most common pattern of coagulopathy observed in patients hospitalized with COVID-19 is characterized by elevations in fibrinogen and D-dimer levels and mild prolongation of PT/aPTT [ 11 ], some previous studies showed that the coagulopathy in patients hospitalized with COVID-19 is characterized by increase in INR too. A prospective cross-sectional study was conducted among 455 COVID-19 patients admitted at the COVID-19 care and treatment center, Ethiopia, from July 1 to October 23, 2020, which showed that prolonged INR was more frequent among severe and critical COVID-19 patients [ 12 ].…”