Hemostatic Factors and Its Correlation with Outcomes of COVID-19 Confirmed Patients in Ulin Regional Hospital Banjarmasin
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Published:
Dec 14, 2021
Keywords:
COVID-19, coagulopathy, hemostatic factor, outcome
Main Article Content
Abstract
Background: Corona Virus Disease (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) has become a Global Pandemic and has spread to more than 200 countries including Indonesia. Previous studies show that poor prognosis has a correlation with coagulopathy conditions.
Objectives: To identify coagulopathy condition and its correlation with the outcomes of COVID-19 confirmed patients at Ulin Regional Hospital Banjarmasin in the period March-August 2020.
Methods: A retrospective study by extracting laboratory data from medical record of 309 patients confirmed with COVID-19 at Ulin Regional Hospital Banjarmasin in the period March-August 2020.
Results: This study showed that mean values of D-Dimer level in the COVID-19 cases were increased both in survivor and non survivor cases. The mean values of PT, APTT, INR and D-Dimer were higher in non survivor cases (PT 12.31 seconds; APTT 31.78 seconds; INR 1.15; D-Dimer 4.6 mg/L) than survivor case (PT 11.63 seconds; APTT 28.43 seconds; INR 1.12; D-Dimer 2.31 mg/L) while the platelet count was the opposite (288.28 in survivor cases; 281.89 in non survivor cases). The difference was statistically significant (P <0.005) in PT, APTT and D-Dimer variables between survivor and non survivor cases. However, the relationship between hemostasis factors and outcome of patient with COVID-19 was found to be very weak on the platelets, PT, APTT and INR variables (ρ = 0-0.25; P <0.005) and weak on the D-Dimer variable (ρ = 0.26-0.50; P <0.005).
Conclusions: Most COVID-19 cases cause coagulopathy conditions. However, considering the risk of poor outcomes, further studies should investigate the prognostic role of hemostatic parameters in COVID-19 patients.
Article Details
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Research Articles
References
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Indonesia Minister of Health. Indonesia Ministry of Health. 2020. Guidelines for the Prevention and Control of Coronavirus Disease (COVID-19). Indonesia Ministry of Health. 0–115. https://infeksiemerging.kemkes.go.id/download/ REV-05_Pedoman_P2_COVID19_13_Juli_2020_1.pdf
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Fu, Wang, Yuan, et al. 2020.Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. Journal of Infection, 80:656–665. https://doi.org/10.1016/j.jinf.2020.03.041
Nagpal, Narayanasamy, Vidholia, Guo, Shin, Lee, et al. 2020. Imaging of COVID-19 pneumonia: patterns, pathogenesis and advance. Br J Radiol, 93:1-12. https://doi.org/10.1259/bjr.20200538
Long, Nie, Xiang, Li, Zhang, Fu, Ren, Liu, Wang, Wu. 2020. D-dimer and prothrombin time are the significant indicators of severe COVID-19 and poor prognosis. BioMed research international, 2020:1- 20. https://doi.org/10.1155/2020/6159720
Miesbach, Makris. 2020. COVID-19: coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clinical and Applied Thrombosis / Hemostasis, 26:1-7. https://journals.sagepub.com/home/cat
Connors, Levy. 2020. COVID-19 and its implications for thrombosis and anticoagulation. Blood, The Journal of the American Society of Hematology, 135 (23) :2033-2040. http://ashpublications.org/blood/articlepdf/135/23/2033/1743274/bloodbld202000600 0c.pdf
Zhang, Yan, Fan, Liu, et al. 2020. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. Journal of Thrombosis and Haemostasis, 18 (6) :1324-1329. https://doi.org/10.1111/jth.14859
Bilaloglu, Aphinyanaphongs, Jones, Iturrate, Hochman, Berger JS. 2020. Thrombosis in hospitalized patients with COVID-19 in a New York City health system. Jama, 324 (8) :799-801. https://doi.org/10.1001/jama.2020.13372 ACI (Acta Cardiologia Indonesiana) (Vol.7 No.2): 6-12 12
Sakka, Connors, Hékimian, Martin-Toutain, Crichi, Colmegna, et al. 2020. Association between DDimer levels and mortality in patients with coronavirus disease 2019 (COVID-19): a systematic review and pooled analysis. JMVJournal de Médecine Vasculaire, 45:268—274. https://doi.org/10.1016/j.jdmv.2020.05.003
Yu, Li, Chen, Ouyang, Zhang, Zhao, Tang, Luo, Xu, Yang, Huang. 2020. Evaluation of variation in D - dimer levels among COVID-19 and bacterial pneumonia: a retrospective analysis. Journal of Thrombosis and Thrombolysis, 10:1-00. https://doi.org/10.1007/s11239-020-02171-y
Luo, Xu, Du, Kou, Liao, Cheng, Mei, Hu. 2020. Early coagulation tests predict risk stratification and prognosis of COVID-19. Aging (Albany NY), 12 (16):15918-15937. https://doi.org/10.18632/aging.103581
Martín-Rojas, Pérez-Rus, Delgado-Pinos, DomingoGonzález, Regalado-Artamendi, Alba-Urdiales, Demelo-Rodríguez, Monsalvo, Rodríguez-Macías, Ballesteros, Osorio-Prendes. 2020. COVID-19 coagulopathy: an in-depth analysis of the coagulation system. European Journal of Hematology, 105 (6):741-750. https://doi.org/10.1111/ejh.13501
Luo, You, Lu, Fu. 2020. Characteristics of coagulation alteration in patients with COVID-19. Annals of Hematology, 20:1-8. https://doi.org/10.1007/s00277-020-04305-x
Birkeland, Zimmer, Kimchi, Kedan. 2020. Venous Thromboembolism in Hospitalized COVID-19 Patients: Systematic Review. Interactive journal of medical research, 9 (3):1-8. http://www.ijmr.org/2020/3/e22768/
Gómez-Mesa, Galindo-Coral, Montes, Martin. 2020. Thrombosis and coagulopathy in COVID-19. PreProof Journal, 1-35. https://doi.org/10.1016/j.cpcardiol.2020.100742
Tang, Li, Wang, Sun. 2020. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis, 18 (4):844-847. https://doi.org/10.1111/jth.14768
Srivastava, Garg, Bansal, Kumar. 2020. COVID-19 infection and thrombosis. Clinica Chimica Acta, 510:344-346. https://doi.org/10.1016/j.cca.2020.07.046
Hadid, Kafri, Al-Katib. 2020. Coagulation and anticoagulation in COVID-19. Blood Reviews, 1-10. https://doi.org/10.1016/j.blre.2020.100761
Lippi, Favaloro. 2020. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thrombosis and haemostasis, 120 (5):876-878. https://doi.org/10.1055/s-0040- 1709650
Sharp, Ghodke. 2020. D-dimer Levels in COVID-19 Patients and Its Correlation with Age and Gender: A Retrospective Analysis. International Journal of Research and Review, 7 (7):2454-2237. www.ijrrjournal.com
Price, Cabe, Garfield, Wort. 2020. Thrombosis and COVID-19 pneumonia: the clot thickens! European Respiratory Journal, 56 (1):1-5. https://doi.org/10.1183/13993003.01608-2020
Yao, Cao, Wang, Shi, Liu, Luo, Chen, Chen, Yu, Huang, Hu. 2020. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. Journal of intensive care, 8 (1):1-11. https://doi.org/10.1186/s40560- 020-00466-z
Cho, Mc Clelland, Cheng, Kim, Hu, Zenilman, D'Ayala. 2020. Utility of d-dimer for diagnosis of deep vein thrombosis in coronavirus disease-19 infection. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 1-8. https://doi.org/10.1016/j.jvsv.2020.07.009
Di Castelnuovo, De Curtis, Costanzo, Persichillo, Olivieri, Zito, Donati, De Gaetano, Lacoviello. 2020. Association of D-dimer levels with all-cause mortality in a healthy adult population: findings from the MOLI-SANI study. Haematologica, 1; 98 (9): 1476-1480. https://doi.org/10.3324/haematol.2012.083410
Berger, Kunichoff, Adhikari, Ahuja, Amoroso, Aphinyanaphongs, Cao, Goldenberg, Hindenburg, Horowitz, Parnia. 2020. Prevalence and Outcomes of D- Dimer Elevation in Hospitalized Patients With COVID-19. Arteriosclerosis, thrombosis, and vascular biology, 40 (10):2539-2547. www.ahajournals.org/journal/atvb
Huang, Wang, Li, Ren, Zhao, Hu, et al. 2020. Clinical features of patients infected with the 2019 novel coronavirus in Wuhan, China. Lancet, 395:497–506. https://doi.org/10.1016/S0140- 6736(20)30183-5
Jin, Duan, Bao, Gu, Chen, Li, Mao, Chen, Xie. 2020. The values of coagulation function in COVID-19 patients. PLoS ONE, 15 (10):1-12. https://doi.org/10.1371/journal.pone.0241329
Cannegieter, Klok FA. 2020. COVID-19 associated coagulopathy and thromboembolic disease: Commentary on an interim expert guidance. Research and Practice in Thrombosis and Haemostasis, 4