COVID 19 associated coagulopathy

Abstract

Background: Critically ill COVID-19 patients are presented with coagulopathy and disseminated intravascular coagulation like massive clot formation. Consequently, coagulation tests are useful to distinguish severe cases of COVID-19.Objective: to assess the role of prothrombin time (PT), D-dimer, platelet (PLT) count, and fibrinogen for detection of coagulopathy in patients with COVID-19 and to assess their relation to disease severity.Methodology: A cross sectional study was conducted on 80 patients with polymerase chain reaction (PCR) confirmed COVID-19 infection. The presenting symptoms, smoking, comorbidities, and high-resolution computed tomography of chest (HRCT) findings were reported. Measurements of the following laboratory parameters were done; complete blood count, liver and renal function tests, arterial blood gases, erythrocyte sedimentation rate, serum ferritin, C-reactive protein, PT, PTT, D-dimer and fibrinogen. Based on COVID severity criteria, they were classified into mild, moderate, severe, and critical cases.Results: Among the studied cases there were 33.75% have mild, 13.75% moderate, 38.75% severe and 13.75% critical COVID-19 infection. The dyspnea was significantly common in severe and critical groups (p< 0.001), while sore throat was significantly common in mild and moderate groups (p< 0.001). The ferritin was significantly higher in patients with either severe or critical COVID-19 than those with mild COVID-19, and in patients with severe COVID-19 than those with critical COVID-19. The severe and critical groups have significantly higher CORAD???-score compared to either mild or moderate groups. The white blood cells was significantly higher in the critical group than the mild group. The level of D-dimer and fibrinogen were significantly higher in the severe and critical groups compared to either the mild or moderate groups. The PT, PTT, D-dimer and fibrinogen have fair sensitivities and specificities for determination of COVID-19 severity, and for detection of critical COVID-19. Conclusion:Coagulation biomarkers increases in COVID-19 infected patients, and they increased further as the severity of the disease increased.