Analysis of dynamic disturbance in blood coagulation function of patients with Coronavirus Disease 2019: A retrospective observational study

• Published in: Medicine (Baltimore) Vol. 99; no. 43; p. e22635
• Main Authors: Chen, Nian, Li, Yuwen, Fan, Haozhi, Tian, Anran, Yuan, Hui, Jiang, Zhengyi, Yu, Yunxi, Ruan, Lili, Hu, Pingping, Yue, Ming, Li, Jun, Zhu, Chuanlong
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 23.10.2020
• Subjects: Adult; Aged; Aged, 80 and over; Betacoronavirus; Blood Coagulation Disorders - diagnosis; Blood Coagulation Disorders - physiopathology; Blood Coagulation Disorders - virology; Blood Coagulation Tests; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronavirus Infections - physiopathology; COVID-19; Female; Humans; Male; Middle Aged; Observational Study; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - physiopathology; Retrospective Studies; SARS-CoV-2; Severity of Illness Index
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000022635

Coronavirus Disease 2019 (COVID-19) has became a major problem affecting global health security.To assess the differences and dynamic changes of blood coagulation function in COVID-19 patients with different severity.A total of 261 COVID-19 patients from January 24 to March 25, 2020 in Huangshi, Hubei Province were enrolled.We designed a retrospective observational study. Clinical information, including age, blood routine and blood coagulation function, were collected. According to the Diagnosis and Treatment Guidelines for COVID-19 (seventh version) that issued by the National Health Committee of the People's Republic of China, patients were divided into 3 subgroups: 186 ordinary, 45 severe and 30 critical ones. We compared the differences in blood coagulation factors among groups.Average age in critical group (71.47 ± 11.48 years) was the oldest of 3 subgroups. At admission, statistically differences could be observed among ordinary, severe and critical patients in D-dimer (0.18 ± 0.33, 0.63 ± 1.13 and 1.16 ± 1.58 mg/L), fibrinogen/fibrin degradation products (FDP) (3.11 ± 5.30, 9.82 ± 23.91 and 21.94 ± 40.98 μg/ml), platelet [(169 ± 62.85), (188 ± 71.56) and (117 ± 38.31) × 10/L)] and lymphocyte count [(1.18 ± 0.46), (0.82 ± 0.35) and (0.75 ± 0.39) × 10/L)], respectively (P < .05). During hospitalization, the peak values of coagulation and valley values of blood routine were monitored. There were significant differences among ordinary, severe and critical patients in D-dimer (0.26 ± 0.46, 1.39 ± 1.51 and 2.89 ± 1.68 mg/L), FDP (3.29 ± 5.52, 23.68 ± 39.07 and 56.11 ± 49.94 μg/ml), platelet [(164 ± 55.53), (171 ± 69.96) and (84 ± 57.80) × 10/L)] and lymphocyte count [(1.10 ± 0.46), (0.65 ± 0.35) and (0.55 ± 0.31) × 10/L)], respectively (P < .001). D-dimer and FDP in the course of disease in severe/critical groups showed a first upward and then downward trend.We concluded that coagulation function indexes such as D-dimer and FDP could be served as markers to estimate COVID-19 patients condition. Close monitoring of coagulation function may be helpful for early diagnosis of severe patients and guidance of treatments.