Hemostatic System (Fibrinogen Level, D-Dimer, and FDP) in Severe and Non-Severe Patients With COVID-19: A Systematic Review and Meta-Analysis

Rostami, Mehrdad; Khoshnegah, Zahra; Mansouritorghabeh, Hassan

doi:10.1177/10760296211010973

Cited by 22 publications

(13 citation statements)

References 73 publications

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“…In this present study, D-dimer was the best predictor for severe COVID-19 among others with AUC, sensitivity, and specificity of 0.736, 72.3% and 66.4%, respectively. The ability to predict severe cases among COVID-19 patients had been reported previously [51][52][53][54]. The predictive value of D-dimer in this present study is close with that reported previously [50,55].…”

Section: Discussionsupporting

confidence: 92%

Hemostatic and liver function parameters as COVID-19 severity markers

Iqbal,

Mudatsir,

Harapan

et al. 2024

Narra J

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease newly discovered in December 2019 which affects coagulation cascade and liver functions. The aim of this study was to investigate the potential of hemostatic and liver function parameters as severity markers in COVID-19 patients. This study was an observational analytic with cohort retrospective design using total sampling method. Data were retrieved from medical record of COVID-19 patients admitted to provincial hospital in Banda Aceh, Indonesia from March 2020 to March 2022. There were 1208 data eligible for the study after applying certain criteria. Mann–Whitney, logistic regression, and receiving operating characteristic (ROC) analyses were used to analysis the data. Thrombocyte count (p<0.001), prothrombin time (p<0.001), activated partial thromboplastin time (p<0.001), D-dimer (p<0.001), fibrinogen (p<0.001), aspartate aminotransferase (p<0.001), and alanine transaminase (p<0.001) significantly increased in severe compared to mild COVID-19 patients. After being adjusted, age (odds ratio (OR); 1.026 (95% confidence interval (CI): 1.016–1.037) was the most significant factor in predicting COVID-19 severity. Fibrinogen (cut-off 526.5 mg/L) was the best parameter associated with COVID-19 severity with 70% sensitivity and 66.4% specificity. Meanwhile, D-dimer (cut-off 805 ng/mL) had a sensitivity of 72.3% and specificity of 66.4%. Combining the parameters resulted in improved sensitivity to 82.0% with a slight decline of specificity to 65.5%. In conclusion, fibrinogen and D-dimer level on admission could be used as biomarkers in predicting COVID-19 prognosis. Routine monitoring and evaluation of laboratory testing especially D-dimer and fibrinogen could be implemented in order to reduce morbidity and mortality rate of COVID-19.

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Section: Discussionsupporting

confidence: 92%

Hemostatic and liver function parameters as COVID-19 severity markers

Iqbal,

Mudatsir,

Harapan

et al. 2024

Narra J

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“…A major marker for fibrinolytic activity (Figure 2) is a polypeptide referred to as D-dimer Figure 5. It is a strong prognostic indicator for disease outcome (survival) in acute COVID [85,[146][147][148][149][150][151][152][153][154]. It is, in effect, a composite measure of how much fibrinogen there was, how much was converted to fibrin clots (whether normal or fibrinaloids), and how much these then went on to be lysed.…”

Section: Role Of D-dimermentioning

confidence: 99%

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Kell

Laubscher

Pretorius

2022

Biochemical Journal

183

212

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Post-acute sequelae of COVID (PASC), usually referred to as ‘Long COVID’ (a phenotype of COVID-19), is a relatively frequent consequence of SARS-CoV-2 infection, in which symptoms such as breathlessness, fatigue, ‘brain fog’, tissue damage, inflammation, and coagulopathies (dysfunctions of the blood coagulation system) persist long after the initial infection. It bears similarities to other post-viral syndromes, and to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Many regulatory health bodies still do not recognize this syndrome as a separate disease entity, and refer to it under the broad terminology of ‘COVID’, although its demographics are quite different from those of acute COVID-19. A few years ago, we discovered that fibrinogen in blood can clot into an anomalous ‘amyloid’ form of fibrin that (like other β-rich amyloids and prions) is relatively resistant to proteolysis (fibrinolysis). The result, as is strongly manifested in platelet-poor plasma (PPP) of individuals with Long COVID, is extensive fibrin amyloid microclots that can persist, can entrap other proteins, and that may lead to the production of various autoantibodies. These microclots are more-or-less easily measured in PPP with the stain thioflavin T and a simple fluorescence microscope. Although the symptoms of Long COVID are multifarious, we here argue that the ability of these fibrin amyloid microclots (fibrinaloids) to block up capillaries, and thus to limit the passage of red blood cells and hence O2 exchange, can actually underpin the majority of these symptoms. Consistent with this, in a preliminary report, it has been shown that suitable and closely monitored ‘triple’ anticoagulant therapy that leads to the removal of the microclots also removes the other symptoms. Fibrin amyloid microclots represent a novel and potentially important target for both the understanding and treatment of Long COVID and related disorders.

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“…[ 28 , 29 ] Studies have shown that COVID-19 infection can lead to a state of hypercoagulability, evidenced by shortened prothrombin time, increased levels of fibrin degradation products and D-D, which increases the risk of ICH. [ 30 , 31 ] Additionally, COVID-19 infection can cause neuroinflammation and neuron damage, releasing large amounts of inflammatory cytokines and oxygen free radicals, resulting in disruption of the blood-brain barrier and damage to endothelial cells, platelet aggregation, and thrombus formation, further exacerbating ICH. [ 32 , 33 ] Due to the severity and complexity of COVID-19 infection, damage to the cardiovascular and other vital organs may result in poorer prognosis.…”

Section: Discussionmentioning

confidence: 99%

Infection with COVID-19 is a risk factor for poor prognosis in patients with intracranial hemorrhage: A prospective observational cohort study

Wang,

Chen

2023

Medicine

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This research aimed to explore the COVID-19 infection in the prognosis of patients with intracerebral hemorrhage (ICH), as well as analyzed the risk factors of the poor prognosis. This present prospective observational cohort study enrolled 136 patients with ICH who were admitted in our hospital during May 2020 to July 2022. The diagnosis of COVID-19 was confirmed by reverse transcriptase polymerase chain reaction. All patients were collected demographic and clinical data and were followed up for 3 months, and we used the modified Rankin scale (mRS) to assess the prognosis of ICH patients, mRS score ≥ 3 indicated a bad prognosis and mRS score ≤ 2 indicated a good prognosis. All data used SPSS 18.0 for statistical analyses. The mRS score after 3 months of patients in COVID-19 group were also remarkably elevated than that in the patients in control group (P < .05). The levels of fasting plasma glucose (FPG), D-dimer (D-D) were remarkably enhanced in the ICH patients in COVID-19 group compared to the control group (P < .05). The national institutes of health stroke scale scores, hematoma volume, the serum levels of white blood cell, FPG, D-D and the proportion of patients with diabetes were significantly higher while the Glasgow coma scale scores were significantly lower in bad prognosis group (P < .05). In addition, we found a significantly higher rate of COVID-19 infections in ICH patients with poor prognosis (P < .05). Infection of COVID-19, FPG, white blood cell, national institutes of health stroke scale, Glasgow coma scale and hematoma volume were the risk factors for poor prognosis in patients with ICH. This study showed that the proportion of patients with diabetes, the mRS score after 3 months and the levels of FPG, D-D were remarkably elevated in the ICH patients in COVID-19 group compared to the control group. This study may provide the effective preventive and treatment measures for the burden of ICH on families and society.

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Hemostatic System (Fibrinogen Level, D-Dimer, and FDP) in Severe and Non-Severe Patients With COVID-19: A Systematic Review and Meta-Analysis

Cited by 22 publications

References 73 publications

Hemostatic and liver function parameters as COVID-19 severity markers

Hemostatic and liver function parameters as COVID-19 severity markers

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Infection with COVID-19 is a risk factor for poor prognosis in patients with intracranial hemorrhage: A prospective observational cohort study

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