Risk stratification and prognostic value of prothrombin time and activated partial thromboplastin time among COVID-19 patients

Tekle, Esayas; Gelaw, Yemataw; Dagnew, Mulat; Gelaw, Aschalew; Negash, Markos; Kassa, Eyuel; Bizuneh, Segenet; Wudineh, Dessalew; Asrie, Fikir

doi:10.1371/journal.pone.0272216

Cited by 8 publications

(6 citation statements)

References 61 publications

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“…Previous studies had reported significantly prolonged PT in severe compared to non-severe COVID-19 patients [45][46][47][48][49]. In different studies, prolonged PT was found to be capable of distinguishing different severity levels of COVID-19 [17,50]. 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.…”

Section: Discussionsupporting

confidence: 57%

“…They found that the non-survivors were likely to have decreasing or increasing-then-decreasing pattern of thrombocyte count compared to those who survived [42]. Moreover, APTT was previously reported having the predictive ability to differentiate mild from moderate and severe COVID-19 cases [17]. PT, however, was significantly associated with severe COVID-19 in this present study, where its AUC reached 0.598 (still below 0.60).…”

Section: Discussioncontrasting

confidence: 45%

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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: 57%

Section: Discussioncontrasting

confidence: 45%

Hemostatic and liver function parameters as COVID-19 severity markers

Iqbal,

Mudatsir,

Harapan

et al. 2024

Narra J

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“…PT, also known as the time of prothrombin, is a coagulation marker that refers to the blood clotting time [34]. Several reports highlighted the clinical relevance of PT in COVID-19 infection, along with other clotting-related parameters such as platelet count, D-Dimers, and fibrinogen [35][36][37][38]. In glioblastoma, HB-EGF acts as a mediator of coagulation activation, a process triggered by hypoxia exposure of these cells [39].…”

Section: Discussionmentioning

confidence: 99%

HB-EGF Plasmatic Level Contributes to the Development of Early Risk Prediction Nomogram for Severe COVID-19 Cases

Moatar,

Chis,

Nitusca

et al. 2024

Biomedicines

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(1) Background: Heparin-Binding Epidermal Growth Factor-like Growth Factor (HB-EGF) is involved in wound healing, cardiac hypertrophy, and heart development processes. Recently, circulant HB-EGF was reported upregulated in severely hospitalized COVID-19 patients. However, the clinical correlations of HB-EGF plasma levels with COVID-19 patients’ characteristics have not been defined yet. In this study, we assessed the plasma HB-EGF correlations with the clinical and paraclinical patients’ data, evaluated its predictive clinical value, and built a risk prediction model for severe COVID-19 cases based on the resulting significant prognostic markers. (2) Methods: Our retrospective study enrolled 75 COVID-19 patients and 17 control cases from May 2020 to September 2020. We quantified plasma HB-EGF levels using the sandwich ELISA technique. Correlations between HB-EGF plasma levels with clinical and paraclinical patients’ data were calculated using two-tailed Spearman and Point-Biserial tests. Significantly upregulated parameters for severe COVID-19 cases were identified and selected to build a multivariate logistic regression prediction model. The clinical significance of the prediction model was assessed by risk prediction nomogram and decision curve analyses. (3) Results: HB-EGF plasma levels were significantly higher in the severe COVID-19 subgroup compared to the controls (p = 0.004) and moderate cases (p = 0.037). In the severe COVID-19 group, HB-EGF correlated with age (p = 0.028), pulse (p = 0.016), dyspnea (p = 0.014) and prothrombin time (PT) (p = 0.04). The multivariate risk prediction model built on seven identified risk parameters (age p = 0.043, HB-EGF p = 0.0374, Fibrinogen p = 0.009, PT p = 0.008, Creatinine p = 0.026, D-Dimers p = 0.024 and delta miR-195 p < 0.0001) identifies severe COVID-19 with AUC = 0.9556 (p < 0.0001). The decision curve analysis revealed that the nomogram model is clinically relevant throughout a wide threshold probability range. (4) Conclusions: Upregulated HB-EGF plasma levels might serve as a prognostic factor for severe COVID-19 and help build a reliable risk prediction nomogram that improves the identification of high-risk patients at an early stage of COVID-19.

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“…An increase from the baseline PT was associated with worsen prognosis. Therefore, PT can be used as a risk stratification and prognostic marker in COVID-19 patients [24].…”

Section: Discussionmentioning

confidence: 99%

Hematological and Coagulation Features of COVID-19 Patients in Hodeidah, Yemen

Balkam,

Al-Kamarany

2023

IJPR

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Background: The blood parameters are very important markers for the progression of COVID-19 infection and predicator for severity. Objectives: Therefore, the study aimed to describe the hematological and coagulation features of coronavirus disease 2019 (COVID-19) infection. Methodology: The descriptive study (a case series) included 49 patients that were diagnosed clinically and confirmed by the real time – polymerase chain reaction (RT-PCR) with COVID-19. The patients were extremely debilitated, the severe and critical cases were treated in the isolation center (inpatient). Hematological parameters and coagulation tests were measured based on standards methods. Results: The results revealed that 85.7 % of the patients had pretreatment leukocytosis with average count of WBC 15.24 ± 6.18 (×10 9/L). On the other hand, the WBC count, which had reached a peak of 34 (×10 9/L) as maximum value. Also, the reduction of the lymphocytes (lymphopenia) associated with COVID -19 infection was up to 1 % with average (8.75 ± 6.92 %). The neutrophils increased (neutrophilia) to 98 % with average (87.40±8.45%). In addition, the thrombocytopenia was reported in 2/49 cases (4.08 %), and low in hemoglobin (severe anemia) was reported in 5/49 case (10.20 %). The coagulation tests revealed increased in D-dimer levels (p < 0.05) in severe and critical patients. On the other hand, the results showed normal in prothrombin time (PT) and partial thromboplastin time (PTT) (p > 0.05). Conclusion: The study concluded that decrease in lymphocytes (lymphopenia), increase in NLR in patients with severe COVID-19 infection and increase in D-dimer are good predicator for progressive and severity illness in COVID-19 infection.

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Risk stratification and prognostic value of prothrombin time and activated partial thromboplastin time among COVID-19 patients

Cited by 8 publications

References 61 publications

Hemostatic and liver function parameters as COVID-19 severity markers

Hemostatic and liver function parameters as COVID-19 severity markers

HB-EGF Plasmatic Level Contributes to the Development of Early Risk Prediction Nomogram for Severe COVID-19 Cases

Hematological and Coagulation Features of COVID-19 Patients in Hodeidah, Yemen

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