Role of Coagulation Profile in Predicting Disease Severity Among Patients of COVID-19

Saurabh, Animesh; Dey, Biswajit; Raphael, Vandana; Deb, Prakash; Khonglah, Yookarin; Tiewsoh, Iadarilang

doi:10.7759/cureus.19124

Cited by 11 publications

(13 citation statements)

References 15 publications

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“…According to this study, PT (AUC = 0.90) had a good predictive value to stratify mild versus severe/critical patients [46]. Similar multiple studies support that baseline/admission PT had a good risk stratification value among COVID-19 patients [14,32,45,46,[52][53][54][55].…”

Section: Plos Onesupporting

confidence: 79%

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

et al. 2022

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Background COVID-19 is a viral disease caused by a new strain of corona virus. Currently, prognosis and risk stratification of COVID-19 patients is done by the disease’s clinical presentation. Therefore, identifying laboratory biomarkers for disease prognosis and risk stratification of COVID-19 patients is critical for prompt treatment. Therefore, the main objective of this study was to assess the risk stratification and prognostic value of basic coagulation parameters and factors associated with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia. Methods A follow-up study was conducted among conveniently recruited COVID-19 patients attended from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analyzed by the HUMACLOT DUE PLUS® machine. Descriptive statistics were used to summarize the socio-demographic and clinical characteristics of study participants. Kruskal Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. The area under the receiver operating characteristic curve (AUC) was used to evaluate the value of PT and APTT in the risk stratification and disease prognosis of COVID-19 patients. Ordinal logistic regression was used to identify the factors associated with disease severity and prognosis. A P-value < 0.05 was defined as statistically significant for all results. Result Baseline PT at a cut-off value ≥ 16.25 seconds differentiated severe COVID-19 patients from mild and moderate patients (AUC: 0.89, 95% CI: 0.83–0.95). PT also differentiated mild COVID-19 patients from moderate and severe patients at a cut-off value ≤ 15.35 seconds (AUC: 0.90, 95% CI: 0.84–0.96). Moreover, alcohol drinkers were a 3.52 times more likely chance of having severe disease than non-drinkers (95% CI: 1.41–8.81). A one-year increment in age also increased the odds of disease severity by 6% (95% CI: 3–9%). An increment of ≥ 0.65 seconds from the baseline PT predicted poor prognosis (AUC: 0.93, 0.87–0.99). Conclusions and recommendations Prolonged baseline PT was observed in severe COVID-19 patients. Prolonged baseline PT was also predicted to worsen prognosis. 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.

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Section: Plos Onesupporting

confidence: 79%

“…Additionally, the current study revealed that one year increment in patient age was increased the odds of severity by 6% (95 CI: 3-9%). Recent studies also revealed that the severity of COVID-19 was high in older age groups [31,55,[60][61][62][63]. Aging changes the immune system, mitochondrial function, and hormone levels.…”

Section: Plos Onementioning

confidence: 99%

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

et al. 2022

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“…Additionally, in our findings it was observed that D-dimer had a high sensitivity (76%), the same as PT. Various studies have concluded that D-dimer has a better value in predicting patients who are likely to progress to severe cases [ 18 , 19 ]. Furthermore, in the meta-analysis performed by Zhao et.al, it is noted from their results that elevated D-dimer levels are an independent predictor of both mortality and complications [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania

Cîtu

Burlea²,

Gorun

et al. 2022

JCM

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SARS-CoV-2 infection produces alterations in blood clotting, especially in severe cases of COVID-19. Abnormal coagulation parameters in patients with COVID-19 are important prognostic factors of disease severity. The objective of this study was to evaluate the predictive value of aPTT, D-dimer, INR and PT in the mortality of patients with COVID-19. A retrospective, single-center, observational study was conducted on COVID-19 patients admitted to the Municipal Emergency Clinical Hospital in Timisoara, Romania, between August and October 2021. Patients were confirmed as COVID-19 positive by reverse transcription-polymerase chain reaction (RT-PCR) assay. After applying the inclusion/exclusion criteria, a total of 82 patients were included in the analysis. Receiver operating characteristic (ROC) curves of D-Dimer, INR, PT and aPTT were generated to assess whether the baseline of each of these biomarkers was accurately predictive for mortality in patients with COVID-19. Mortality among patients enrolled in this study was 20.7%, associated with older age and presence of heart disease. The areas under the ROC curve (AUC-ROC) of D-Dimer, INR, PT, and aPTT were 0.751, 0.724, 0.706 and 0.753. Differences in survival for patients with coagulation biomarker levels above cut-off values compared to patients below these values were statistically significant. All evaluated parameters had significant differences and good performance in predicting mortality of COVID-19 patients, except fibrinogen, which had no significant difference. Moreover, aPTT and D-dimer were the best performing parameters in predicting mortality in patients with SARS-CoV-2 infection.

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“…Patients having any one of these—respiratory rate > 30/min, breathlessness, or SpO2 < 90% on room air—were admitted to ICU [ 4 , 5 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients

Saurabh

Dey

Raphael

et al. 2022

SN Compr. Clin. Med.

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Hematological parameters like total leukocyte count (TLC), neutrophil, lymphocyte, and absolute eosinophil counts (AEC), and neutrophil-to-lymphocyte ratio (NLR) are known to predict the severity of novel coronavirus disease 2019 (COVID-19) patients. In the present study, we aimed to study the role of complete blood count parameters in triaging these patients requiring intensive care unit (ICU) admission. A retrospective study was done over a period of 2 months. Patients, who were ≥ 18 years of age with COVID-19 confirmed on SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) and whose routine hematology counts were sent within 24 h of admission, were included in the study. Cut-off values of 47.5 years for age, 11.3 × 10 9 /L for TLC, and 9.1 for NLR were predictive of disease severity among COVID-19 patients. Relative neutrophilia ≥ 70% ( p < 0.007), relative lymphopenia ≤ 20% ( p < 0.002), AEC ≤ 40/cumm ( p < 0.001), and NLR ≥ 9.1 ( p < 0.001) were significantly associated with ICU admission. Routine hematological parameters are cost-effective and fast predictive markers for severe COVID-19 patients, especially in resource-constrained health care settings to utilize limited ICU resources more effectively.

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Role of Coagulation Profile in Predicting Disease Severity Among Patients of COVID-19

Cited by 11 publications

References 15 publications

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

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

Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania

Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients

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