Characteristics of coagulation alteration in patients with COVID-19
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ORIGINAL ARTICLE
Characteristics of coagulation alteration in patients with COVID-19 Hong-chun Luo 1 & Cheng-yan You 2,3,4 & Si-wei Lu 2,3,4 & Yue-qiang Fu 2,3,4,5 Received: 6 May 2020 / Accepted: 15 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Abnormal blood coagulation often occurs in critically ill patients, which seriously affects their prognosis. This retrospective study investigated the implications of changes in blood coagulation in patients with coronavirus disease 2019 (COVID-19). Records were reviewed for patients admitted with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital death. A total of 85 patients were included, of whom 12 died in the hospital. The admission prothrombin time (PT), international normalized ratio (INR), and levels of D-dimer and fibrin/fibrinogen degradation products (FDP) were significantly higher in nonsurvivors than in survivors, while the reverse was true for prothrombin time activity (PT-act) and PaO2/FiO2. Multivariate logistic regression showed that PT-act < 75% was independently associated with mortality. The area under the receiver operating characteristic curves for PT-act, D-dimer, and FDP at admission could significantly predict mortality. The AUCs for PT-act were larger than those for D-dimer and FDP; however, there was no significant difference. After 2 weeks of treatment, the coagulation parameters of the surviving patients improved. COVID-19 is often accompanied by abnormal coagulation. PT-act at admission is able to predict mortality in patients with COVID-19 as can D-dimer and FDP levels. PT-act < 75% is independently associated with mortality. Keywords COVID-19 . Death . Blood coagulation . Prothrombin time activity . D-Dimer
Introduction An unknown pneumonia broke out in Wuhan City in December 2019, and it was confirmed as an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, formerly known as 2019-nCoV). The disease was subsequently named coronavirus disease 2019 (COVID-19) by the WHO on February 11,
* Yue-qiang Fu [email protected] 1
Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
2
Department of Critical Care Medicine, Children’s Hospital, Chongqing Medical University, 136# Zhongshan Er Road, Yu Zhong District, Chongqing 400014, People’s Republic of China
3
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, People’s Republic of China
4
National Clinical Research Center for Child Health and Disorders (Chongqing), Chongqing 400014, People’s Republic of China
5
Third Batch Chongqing Medical Aid Team to Wuhan City of Hubei Province, Chongqing, People’s Republic of China
2020. SARS-CoV-2 is highly contagious and can cause serious lung injury, resulting in death, and COVID-19 has been widely spreading and causing great damage in many countries around the world. Pneumonia, especially severe pneumo
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