Correlation of coagulation parameters with clinical outcomes in Coronavirus-19 affected minorities in United States: Observational cohort

Abstract

Importance: has caused a worldwide illness and New York has become the epicenter of COVID-19 in the United States. Currently Bronx has the highest prevalence per capita in New York.Objective: To investigate the coagulopathic presentation of COVID and its natural course and to investigate whether hematologic and coagulation parameters can be used to assess illness severity and death. Design: Retrospective case study of positive COVID inpatients between 3/20/2020-3/31/2020. Setting: Montefiore Health System main hospital, Moses, a large tertiary care center in the Bronx. Participants: Adult inpatients with positive COVID tests hospitalized at MHS. Exposure (for observational studies): Datasets of participants were queried for physiological, demographic (age, sex, socioeconomic status and self-reported race and/or ethnicity) and laboratory data. Main Outcome and Measures: Relationship and predictive value of measured parameters to mortality and illness severity.Results: Of the 217 in this case review, 70 died during hospitalization while 147 were discharged home. Only the admission PT and first D-Dimer could very significantly differentiate those who were discharged alive and those who died. Logistic regression analysis shows increased odds ratio for mortality by first D-Dimer within 48 hrs. of admission. The optimal cutpoint for the initial D-Dimer to predict mortality was found to be 1.65 g/mL Conclusions:We describe here a comprehensive assessment of hematologic and coagulation parameters in COVID and examine the relationship of these to mortality. We demonstrate that both initial and maximum D-Dimer values are biomarkers that can be used for survival assessments.

Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

“…A few studies showed that individuals with obesity may decrease in‐hospital mortality 31,75,87,89 . Some studies showed that obesity may insignificantly decrease 41,47,81,90 or increase 55,67,68,84,91–96 the odds of death among individuals with obesity. The majority of studies showed that obesity significantly increased the odds of death among COVID‐19 patients with obesity.…”

Country differences in hospitalisation, length of stay, admission to Intensive Care Units, and mortality due to SARS-CoV-2 infection at the end of the first wave in Europe: a rapid review of available literature

“…However median LOS outlined by studies based in North America were more variable and reported lengths of stay between 3.8 to 14 days for various resolved groups (Figure 3); however three studies highlight the continuing care groups with extended median ICU stays of 20 [101], 23 [110] and 36 days [96]. The Reyes-Gil et al [90] study was excluded from consideration as it was suspected that all patients contributed to the ICU LOS, even if not admitted to ICU.…”

“…The Italian report (COVID-19 Group, 2020) indicates a median of 9 days (including ICU stay for deceased patients); no estimate of variance was reported. The estimate for Argenziano et al [92] also includes hospital LOS, while Reyes-Gil et al [90] is excluded as it is believed that ICU LOS was calculated with patients who were not admitted to ICU. Studies reporting less than ten patients in ICU [8,57,78,83] were also excluded from Figure 5.…”

Simple Coagulation Profile as Predictor of Mortality in Adults Admitted with COVID-19: A Meta-analysis

“…The pooled effect size demonstrated that PT was significantly higher in non-survivors than in survivors, as shown in Figure 3 [21 studies, SMD = 1.22 (95% CI: 0.71 to 1.72), P < (11) showed no improvement in heterogeneity. Pooled analysis of three studies with categorical data of PT demonstrated increased PT in the non-survivor group [OR = 1.86 (95% CI: 1.43 to 2.43), P < 0.01; I 2 = 2%, P = 0.36] (Figure 3).…”