Markers of coagulation dysfunction and inflammation in diabetic and non-diabetic COVID-19
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RESEARCH LETTER
Markers of coagulation dysfunction and inflammation in diabetic and non‑diabetic COVID‑19 Seshadri Reddy Varikasuvu1 · Saurabh Varshney2 · Naveen Dutt3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Coagulation dysfunction and inflammatory status were compared between diabetic and non-diabetic COVID-19 patients. The standardized mean difference (SMD) and its 95% confidence interval (CI) was computed for the difference of inflammatory and hypercoagulability markers. The levels of serum ferritin (standardized mean difference-SMD: 0.47, CI 0.17–0.77, p = 0.002), C-reactive protein (SMD = 0.53, CI 0.20–0.86, p = 0.002), interleukin-6 (SMD = 0.31, CI 0.09–0.52, p = 0.005), fibrinogen (SMD = 0.31, CI 0.09–0.54, p = 0.007) and D-dimers (SMD = 0.54, CI 0.16–0.91, p = 0.005) were significantly higher in diabetic COVID-19 cases as compared to non-diabetic COVID-19 patients, suggesting more susceptibility of diabetic COVID-19 patients to coagulation dysfunction and inflammatory storm. Keywords COVID-19 · Diabetes · D-dimer · Inflammation
Highlights • The markers of coagulation dysfunction and inflam-
mation were studied between diabetic and non-diabetic COVID-19 patients by meta-analysis. • COVID-19 patients with diabetes have a significantly higher levels of coagulation dysfunction markers such as Fibrinogen (SMD = 0.31, CI 0.09–0.54, p = 0.007) and D-dimers (SMD = 0.54, CI 0.16–0.91, p = 0.005) than the non-diabetic COVID-19 cases. • COVID-19 patients with diabetes have a significantly higher inflammatory markers such as C-reactive protein (SMD = 0.53, CI 0.20–0.86, p = 0.002), Interleukin-6 (SMD = 0.31, CI 0.09–0.52, p = 0.005) than the nondiabetic COVID-19 cases.
* Seshadri Reddy Varikasuvu [email protected] 1
Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand 814152, India
2
All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
3
Department of Respiratory Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
• These results indicate that diabetic COVID-19 patients
are more susceptibility to coagulation dysfunction and inlammatory storm.
Introduction The world is struggling in lockdown for months since December of 2019 due to novel coronavirus disease (COVID-19) outbreak, a pandemic declared by the World Health Organization [1]. Research evidence is growing on the role of several symptoms, comorbidities, inflammation and hypercoagulability markers in relation to disease progression and deaths in COVID-19 patients. The incidence of diabetes, one of the leading causes of morbidity has been shown to be high and is associated with disease progression in COVID-19 [2, 3]. Diabetic patients due to low pulmonary function have been reported to be more susceptible to intensive care admissions, mechanical ventilation and deaths due to COVID-19 than those without diabetes [4, 5]. Though several studies have reported various inflammatory and coagulability mark
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