Meta-analysis of coagulation parameters associated with disease severity and poor prognosis of COVID-19

Int J Infect Dis. 2020 Nov:100:441-448. doi: 10.1016/j.ijid.2020.09.021. Epub 2020 Sep 15.

Abstract

Background: To determine whether abnormal coagulation parameters are associated with disease severity and poor prognosis in patients with 2019 Corona Virus Disease (COVID-19).

Methods: A systematic literature search was conducted using the databases PubMed, Embase, and Web of sciences until April 25, 2020. We included a total of 15 studies with 2277 patients. Platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D), and fibrinogen (FIB) were collected and analyzed. The statistical results were expressed as the effect measured by mean difference (MD) with the related 95% confidence interval (CI).

Results: The PLT level of severe cases was lower than that of mild cases, while the levels of PT, D-D, and FIB were higher than those of mild cases (P < 0.05). The level of APTT had no statistical difference between two groups (P > 0.05). PT of ICU patients was significantly longer (P < 0.05) than that of non-ICU patients. In non-survivors, PT and D-D were higher, yet PLT was lower than that of survivors (P < 0.05). There was no significant difference in APTT between survivors and non-survivors (P > 0.05). The funnel plot and Egger's regression test demonstrated that there was no publication bias.

Conclusions: Our data support the notion that coagulopathy could be considered as a risk factor for disease severity and mortality of COVID-19, which may help clinicians to identify the incidence of poor outcomes in COVID-19 patients.

Keywords: COVID-19; Coagulation parameters; Coagulopathy; Laboratory; Prognosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Betacoronavirus*
  • Blood Coagulation*
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / mortality
  • Cross-Sectional Studies
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Pandemics
  • Partial Thromboplastin Time
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / mortality
  • Prognosis
  • Prothrombin Time
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D