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

• Main Authors: Aining Zhang, Yan Leng, Yi Zhang, Kefan Wu, Yelong Ji, Shaoqing Lei, Zhongyuan Xia
• Format: Article
• Language: English
• Published: Elsevier 2020-11-01
• Series: International Journal of Infectious Diseases
• Subjects: COVID-19; Coagulation parameters; Coagulopathy; Laboratory; Prognosis
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971220307372

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.