PATTERN OF COAGULATION PARAMETERS IN PATIENTS WITH COVID-19 - A SINGLE CENTRE BASED STUDY
Keywords:Activated Partial Thromboplastin Time (APTT), Coronavirus Disease - 2019 (COVID-19), Domain- dimer (D-dimer), Prothrombin Time (PT)
Objective: To determine prognostic significance of coagulation parameters in patients with COVID-19.
Study Design: A prospective comparative study.
Place and Duration of Study: Department of Haematology, Army Medical College, Pak Emirates Military Hospital, Rawalpindi, from Apr to May 2020.
Methodology: A total of 248 patients diagnosed with COVID-19 of all ages irrespective of gender were enrolled. Their coagulation parameters were assessed and comparisons were made between patients with mild/moderate (non-critical) disease against those with severe/critically ill (critical).Performa was designed and data was analyzed using SPSS 26.
Results: Patients in the critical group revealed constantly elevated levels of Domain-dimer (D-dimer, ng/ml -73.7% vs. 50.5%, 89.5% vs. 39%, 78.9 vs. 41.9%, 77.8% vs. 42%), increased activated partial thromboplastin time (APTT - 34.68 vs. 32.17 sec, 38.84 vs. 32.40 sec, 37.58 vs. 32.50 sec , 37.94 vs. 32.61 sec) and prothrombin time (PT - 14.26 vs. 14.20 sec, 14.79 vs. 14.08 sec, 14.68 vs. 14.10 sec, 15 vs. 14.25 sec) compared to noncritical group (p<0.05). Moreover, higher fibrinogen levels were associated with severe disease (296.32 vs257.92 mg/dl, 280.53 vs. 262.64 mg/dl, 274.74 vs. 264.42 mg/dl, 270.56 vs. 263.10 mg/dl).
Conclusion: Deranged coagulation parameters were observed in patients with COVID-19 and significantly higher in those with severe cases. Regular monitoring of D-dimer, fibrinogen, APTTand PT can provide good accuracy in predicting the severity of disease.