Journal Article

D-Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID-19 and Poor Prognosis

Long, Hui, Liu, Wanxin, Nie, Lan, Fu, Xiaozhi, Zhang, Xiaoli, Li, Huan, Wang, Qiang, Wu, Qingming, Xiang, Xiaochen, Ren, Hongwei

2020

Overview

Objective. To investigate the value of coagulation indicators D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (Fg) in predicting the severity and prognosis of COVID-19. Methods. A total of 115 patients with confirmed COVID-19, who were admitted to Tianyou Hospital of Wuhan University of Science and Technology between January 18, 2020, and March 5, 2020, were included. The dynamic changes of DD, PT, APTT, and Fg were tested, and the correlation with CT imaging, clinical classifications, and prognosis was studied. Results. Coagulation disorder occurred at the early stage of COVID-19 infection, with 50 (43.5%) patients having DD increased and 74 (64.3%) patients having Fg increased. The levels of DD and Fg were correlated with clinical classification. Among 23 patients who deceased, 18 had DD increased at the first lab test, 22 had DD increased at the second and third lab tests, and 18 had prolonged PT at the third test. The results from ROC analyses for mortality risk showed that the AUCs of DD were 0.742, 0.818, and 0.851 in three times of test, respectively; PT was 0.643, 0.824, and 0.937. In addition, with the progression of the disease, the change of CT imaging was closely related to the increase of the DD value (P<0.01). Conclusions. Coagulation dysfunction is more likely to occur in severe and critically ill patients. DD and PT could be used as the significant indicators in predicting the mortality of COVID-19.

• Publisher: Hindawi Publishing Corporation,Hindawi,John Wiley & Sons, Inc
• Subject: Adult / Aged / Aged, 80 and over / Betacoronavirus / Blood / Blood Coagulation Disorders - etiology / Blood Coagulation Disorders - mortality / Blood coagulation factors / China / China - epidemiology / Coagulation / Computed tomography / Coronavirus Infections - blood / Coronavirus Infections - complications / Coronavirus Infections - mortality / Coronaviruses / COVID-19 / Dimers / Disease Progression / Female / Fibrin / Fibrin Fibrinogen Degradation Products - metabolism / Fibrinogen / Fibrinogen - metabolism / Health aspects / Humans / Identification / Indicators / Laboratories / Laboratory tests / Lung - diagnostic imaging / Male / Medical examination / Medical imaging / Medical research / Medicine, Experimental / Middle Aged / Mortality / Pandemics / Partial Thromboplastin Time / Patients / Pneumonia / Pneumonia, Viral - blood / Pneumonia, Viral - complications / Pneumonia, Viral - mortality / Prognosis / Prothrombin / Prothrombin Time / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Thrombin / Thrombin Time / Thromboplastin / Tomography, X-Ray Computed / Viral diseases