Comparison of Coagulation Parameters between Severe and Non-severe COVID-19 Patients Treated in a Tertiary Hospital in Indonesia

Pandji Irani Fianza, Delita Prihatni, Dasep Bambang Purnama

Abstract


Objective: To determine the differences in coagulation features in patients with severe versus non-severe COVID-19.

Method: During the period of the study from July 2020 to June 2021, 371 COVID-19 patients were treated at Dr. Hasan Sadikin Hospital. These patients were divided into two groups based on the WHO critera into severe COVID-19 with clinical signs such as severe acute respiratory syndrome to respiratory failure and non-severe cases with no respiratory symptoms. Data analyzed were Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT), International Normalized Ratio (INR), fibrinogen, D-dimer, and platelet count.

Results: Median INR was significantly higher in patients with severe cases than in non-severe cases (1.04 vs. 0.94, p<0.001), which was also true for median PT (12.3 vs. 12.0 sec, p=0.030) and median fibrinogen (522 vs. 428.5 mg/dl, p=0.004). Similarly, the median D-dimer was significantly higher in severe patients (1.91 vs. 0.75 mg/dl, p<0.001). Median aPTT and platelet count were in normal limits for both severe and non-severe COVID-19 patients (28.6 vs. 29.15 sec, p>0.652 and 246 vs. 242 x103/mm3, p>0.924, respectively).

Conclusions: The INR, PT, fibrinogen, and D-dimer can be considered as features that can be used to predict the severity of the disease and to choose the proper treatment for COVID-19 patients.


Keywords


Coagulopathy disorders, COVID-19, severe acute respiratory syndrome, non-severe acute respiratory syndrome

Full Text:

PDF

References


  1. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. 2021. Available from: https://covid19.go.int/.
  2. Badan Nasional Penanggulangan Bencana. Tingkat Kematian (CFR) Covid-19 Indonesia. 2021. Available from: https://bnpb.go.id/.
  3. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631–7. doi:10.1002/path.1570
  4. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi:10.1016/j.jaut.2020. 102433
  5. Soeroto AY SP, Pranggono EH, Kulsum ID, Suryadinata H,. Pedoman diagnostik dan pengobatan COVID-19. Indones J Chest Crtitical Emerg Med. 2020;1:7.
  6. Mackman N, Antoniak S, Wolberg AS, Kasthuri R, Key NS. Coagulation abnormalities and thrombosis in patients infected with SARS-CoV-2 and other pandemic viruses. Arterioscler Thromb Vasc Biol. 2020;40(9):2033–44. doi:10.1161/ATVBAHA.120.314514
  7. Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. doi:10.1016/j.thromres.2020.04.024
  8. Dahler C, Rechner GA, Mitsios JV. Pathophysiology of COVID-19-associated coagulopathy and its impact on laboratory measures of coagulation. J Pathogen. 2021:30.
  9. Becker RC. COVID-19 update: Covid-19-associated coagulopathy. J Thromb Thrombolysis. 2020;50(1):54–67. doi:10.1007/s11239-020-02134-3
  10. Lazzaroni MG, Piantoni S, Masneri S, et al. Coagulation dysfunction in COVID-19: The interplay between inflammation, viral infection and the coagulation system. Blood Rev. 2021;46:100745. doi:10.1016/j.blre.2020.100745
  11. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13. doi:10.1016/S0140-6736(20)30211-7
  12. Loo J, Spittle DA, Newnham M. COVID-19, immunothrombosis and venous thromboembolism: biological mechanisms. Thorax. 2021;76(4):412–20. doi:10.1136/thoraxjnl-2020-216243
  13. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438–e440. doi:10.1016/S2352-3026(20)30145-9
  14. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18(9): 2103–9. doi:10.1111/jth.14975
  15. Kim ES, Chin BS, Kang CK, et al. Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: a preliminary report of the first 28 patients from the Korean Cohort Study on COVID-19. J Korean Med Sci. 2020;35(13):e142. doi:10.3346/jkms.2020.35.e142
  16. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020;506:145–8. doi:10.1016/j.cca.2020.03.022




DOI: https://doi.org/10.15850/ijihs.v11n2.2967

Article Metrics

Abstract view : 109 times
PDF - 60 times



 

This Journal indexed by

               

          


Creative Commons License
IJIHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License



View My Stats