The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients

Abstract

Introduction: COVID-19 is currently a global pandemic, and coagulation-related mortality has been widely reported in patients suffering from it. Objective: this article aimed to investigate the coagulation profile of COVID-19 patients. Methods: This was a cross-sectional study conducted using a retrospective research design. We recruited patients with COVID-19 admitted to a hospital from June 15th to July 7th, 2020. Upon patients' entering a blood sample was drawn from each patient for assessing patient’s coagulation profile (PT, PTT, INR, Platelet count); and a chest high-resolution computed tomography (HRCT) scan was performed for each patient. The study patients were divided in to sever group (CO-RADS score 5) and non-sever group (CO-RADS score <5). Results: Thirty-six patients (20 males and 16 females) with a mean age of 54.7±17.5 years were studied. Of them, 11 cases (30.56%) had severe pulmonary involvement. Also, the coagulation profiles were longer in the severe group than non-sever group. As well, the means of platelet count that were 232.440 per microliter in the non-severe group and 289.180 per microliter in the severe and non-sever groups, respectively; but still not statistically significant (p>0.05). The Area under the ROC Curve (AUC) for PT and INR was 0.615 and 0.611, respectively. The AUC for platelet count was 0.680 (95% CI: 0.501 to 0.859) and had an acceptable discriminating power. Conclusions: In this study, we did not find any statistically significant relationship between the results of coagulation tests and the severity of pulmonary involvement according to HRCT scan findings in COVID-19 patients. But further analyses suggest that, except PTT, the other coagulation tests (PT, INR, and platelet count) may discriminate severe COVID-19 patients.

1. Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, et al. Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol. 2020;115(6):916-23.
2. Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MU, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med. 2020;27(2):taaa008.
3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
4. Nejati A, Afzalimoghaddam M, Seyedhosseini-Davarani S, Akhgar A. Clinical Recommendation for Emergency Physicians to Approach to Signs and Symptoms Related to COVID-19; a Preliminary Study. Adv J Emerg Med. 2020;4(2s):e56.
5. Naderpour Z, Saeedi M. A primer on covid-19 for clinicians: clinical manifestation and natural course. Adv J Emerg Med. 2020;4(2s):e62.
6. Williams DR, Cooper LA. COVID-19 and health equity—a new kind of “herd immunity”. JAMA. 2020;323(24):2478-80.
7. Han H, Yang L, Liu R, Liu F, Wu K-l, Li J, et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin Chem Lab Med. 2020;58(7):1116-20.
8. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
9. Prokop M, Van Everdingen W, van Rees Vellinga T, Quarles van Ufford H, Stöger L, Beenen L, et al. CO-RADS: a categorical CT assessment scheme for patients suspected of having COVID-19—definition and evaluation. Radiology. 2020;296(2):E97-104.
10. 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.
11. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
12. Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: retrospective cohort study. Platelets. 2020;31(4):490-6.
13. Zulfiqar A-A, Lorenzo-Villalba N, Hassler P, Andrès E. Immune thrombocytopenic purpura in a patient with Covid-19. N Engl J Med. 2020;382(18):e43.
14. Cooper N, Ghanima W. Immune thrombocytopenia. N Engl J Med. 2019;381(10):945-55.
15. Salehi M, Edalatifard M, Taslimi R, Ghiasvand F, Khajavirad N, Mirfazaelian H. Fighting COVID-19: What Are the Available Options? Adv J Emerg Med. 2020;4(2s):e65.
16. Hung IFN, Lung KC, Tso EYK, Liu R, Chung TWH, Chu MY, et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial. Lancet. 2020;395(10238):1695-704.
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IssueVol 5 No 3 (2021): Summer (July) QRcode
SectionOriginal article
DOI 10.18502/fem.v5i3.5893
Keywords
Blood Coagulation COVID-19 Lung Severity of Illness Index
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ebrahimi M, Abiri S, Rayat Dost E, Rahmanian F, Foroughian M, Abbasi A, Abdi MH, Keshavarz P, Hatami N, Kalani N, Haghbeen M. The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients. Front Emerg Med. 2021;5(3):e31.

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