Prognostic Impact of Coagulopathy in Patients with COVID-19: a Meta-analysis of 35 Studies and 6427 Patients

Polimeni, Alberto; Leo, Isabella; Spaccarotella, Carmen; Mongiardo, Annalisa; Sorrentino, Sabato; Sabatino, Jolanda; Rosa, Salvatore De; Indolfi, Ciro

doi:10.21203/rs.3.rs-31142/v1

Cited by 4 publications

(4 citation statements)

References 48 publications

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“…It has been reported that patients with non-severe disease have a lower level of D-Dimer as compared to those with severe disease. 24 Our sample was a homogenous one including only cases with severe disease admitted to intensive care unit. To the best of our knowledge, this is the rst study from South Asia on the role of biomarkers in severe COVID-19.…”

Section: Resultsmentioning

confidence: 99%

Do Laboratory Biomarkers Predict Survival in Severe COVID-19? A Cross-sectional Study

Bahadur¹,

Rahim

Amin

et al. 2020

Preprint

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BackgroundAvailable research compared serum biomarkers such as lymphocyte count, C-reactive protein, ferritin, Lactate Dehydrogenase and D-dimers to predict survival in patients with mild, moderate and severe COVID-19. This study aims to compare these biomarkers among survivors and non-survivors of severe COVID-19. MethodsThis was a cross-sectional study based on patient’s data retrieved from Hospital Information System. Sixty-nine patients for whom a record of the biomarkers and survival status was available, were included in the study. For every patient, baseline and peak values were selected for CRP level, serum ferritin level, serum LDH level and serum D-Dimer level. Similarly, baseline and trough levels were selected for lymphocytes. Data were analyzed using SPSS version 21. Mean and standard deviation was used to compare the biomarkers with paired t-test. P value less than 0.05 was taken as significant. ResultsThe mean age of the study population was 55.5±9.1 years and 72.5% were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87 ±8.4 mg/dl, p=0.45) while among the non-survivor, the increase in CRP level was significant (from 16.68± 10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in serum LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while there was a statistically significant increase in serum LDH level in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). Lymphocyte count decreased significantly in both survivors (p=0.001) and non-survivors (p=0.001). There was no statistically significant elevation in serum ferritin among the survivors and non-survivors (p > 0.05). The D-Dimer level increased significantly in both survivors (p=0.01) and non-survivors (p=0.001).Conclusions In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.Trial Registration Not applicable

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Section: Resultsmentioning

confidence: 99%

Do Laboratory Biomarkers Predict Survival in Severe COVID-19? A Cross-sectional Study

Bahadur¹,

Rahim

Amin

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…It has been reported that patients with non-severe disease have a lower level of D-Dimer as compared to those with severe disease. 24 Our sample was a homogenous one including only cases with severe disease admitted to intensive care unit. To the best of our knowledge, this is the first study on the role of biomarkers in COVID-19 patients admitted to intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

Do Laboratory Biomarkers Predict Survival in Severe Covid-19? A Cross-Sectional Study

Bahadur¹,

Rahim²,

Amin

et al. 2022

J Ayub Med Coll Abbottabad

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Background: This study aims to compare lymphocyte count, C-reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH) and D-dimer among survivors and non-survivors of severe COVID-19. Methods: This retrospective cross-sectional analytical study included 69 patients for whom a record of the biomarkers and survival status was available. Baseline and peak values were selected for serum CRP, ferritin, LDH and D-Dimer. Baseline and trough lymphocyte counts were selected. Data were analyzed using SPSS version 21. Mean and standard deviation were used to compare the biomarkers with paired t-test. p-value <0.05 was taken as significant. Results: The mean age of the study population was 55.5±9.1 years and 50 (72.5%) were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87±8.4 mg/dl, p=0.45) while it was significant in non-survivors (from 16.68±10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while it increased significantly in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). The decrease in lymphocyte count and increase in D-Dimers in both the groups was significant (p=0.001). There was no significant elevation in ferritin in both the groups (p>0.05). Conclusion: In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.

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“…Patients with COVID-19 infection have worse prognosis if they develop coagulopathy during the course of the disease (40) . Older age, the presence of certain comorbidities or underlying conditions, and some image findings related to coagulation abnormalities are also associated with mortality in COVID-19 infection (41) .…”

Section: Stratification Of Coagulation State In Patientsmentioning

confidence: 99%

Coagulopathy and Covid-19: A Review for Medical Practice.

Porter¹,

Arellano²,

Añazco³

et al. 2021

RMV

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In December 2019, an outbreak of a new coronavirus disease (formally known as COVID-19) was first reported in Wuhan, China, and soon spread around the world. On March 11, 2020, COVID-19 was declared as a pandemic by the World Health Organization (WHO). So far, COVID-19 has proven to be a disease with multiorgan involvement, affecting the hematological system as well. Patients with COVID-19, especially those with moderate to severe disease, frequently experience a coagulopathy associated with a high incidence of thrombotic events, which leads to poor outcomes. The pathogenesis of COVID-associated coagulopathy (CAC), is not fully understood yet, although the host inflammatory response to the infection appears to be a crucial element in the development of CAC. IL2, IL-6, IL7, G-CSF, PI10, MIP1, and TNF alpha, among other molecules, act as proinflammatory cytokines that stimulate endothelium damage and alter the coagulation homeostasis. CAC usually manifests as venous thromboembolisms (VTE). While bleeding can also occur, it is a rare form of presentation. Inpatients with COVID-19 must receive thromboprophylaxis, mainly with low-molecular-weight heparin (LMWH); unfractioned heparin can be accepted under certain circumstances. Patients with a diagnosis or high suspicion of VTE should receive the complete doses of anticoagulation treatment and must continue on it for at least three months. Recommendations regarding prophylaxis and treatment may vary among institutions and countries. There is not clear evidence for the regular use of antiplatelet therapy in patients with COVID-19. This review will provide key insights regarding the pathophysiology, clinical manifestations, diagnosis and treatment of COVID-19 and its associated coagulopathy.

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Prognostic Impact of Coagulopathy in Patients with COVID-19: a Meta-analysis of 35 Studies and 6427 Patients

Cited by 4 publications

References 48 publications

Do Laboratory Biomarkers Predict Survival in Severe COVID-19? A Cross-sectional Study

Do Laboratory Biomarkers Predict Survival in Severe COVID-19? A Cross-sectional Study

Do Laboratory Biomarkers Predict Survival in Severe Covid-19? A Cross-Sectional Study

Coagulopathy and Covid-19: A Review for Medical Practice.

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