ABSTRACT
Covid-19 is a severe acute respiratory syndrome, the disease presents with a ranging from asymptomatic to severe symptomatic illness with multiple organ failure and death, and can cause a severe effect on the coagulation system. This study aimed to determine the effect of the covid 19 on the extrinsic and intrinsic pathway of coagulation [prothrombin time(PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT)] and to determine the association of age and gender with the severity of COVID-19 in Sudan in order to improve the outcome. A cross-sectional study carried out among 487 COVID-19 patients attending Khartoum State. COVID-19 patients were confirmed by RT-PCR. For all patients, the prothrombin times (PT), International normalized ratio (INR), and Activated partial thromboplastin (APTT) were estimated by using a semi-automated coagulometer analyzer. Patients were divided into three subclass groups according to the Severity of COVID-19 (mild, severe in the emergency room) (ER) and intensive care unit (ICU), and the clotting factors values were compared between the groups. The results were statically analyzed by spss version 21 for data analysis. These results showed statistically significant increased Levels of PT, INR, and APTT for all (P. value = 0.000), compared to the control group. Also, the levels of coagulation tests were higher in ICU COVID-19 patients (P. value = 0.000) compared to mild and severe subgroups. This study concluded that: coagulation clotting times were increased in COVID-19 patients, especially among patients in ICU which could be a marker for DIC and even death.
ABSTRACT
The relevance of coagulation malfunction in COVID-19 (severe coronavirus disease) is ambiguous. Current study aimed to assess the coagulation among SARS-CoV-2 hospitalized patients. A cross sectional study with qualitative approach was conducted among 300 patients who are already diagnosed as COVID 19 compared to 300 apparently healthy control group attended to Red Sea State during study period from April 2020 to April 2021. The Humaclot Due Plus1 coagulation analyser was used to estimate the prothrombin time (PT), activated partial prothrombin time (APTT), and international normalized ratio (INR) (Wiesbaden 1, Germany), adding 25 μL of plasma in cuvette. The study result showed that in COVID-19 patients D.dimer level is high (2000-10000 ng/mL) compared with control group (up to 500 ng/mL). COVID-19 infection cause high D. dimer level which can lead to thrombosis event or bleeding tendency. Abnormal coagulation results were revealed among SARS-CoV-2, with markedly elevated D. dimer.
ABSTRACT
OBJECTIVE: The aim of the study was to detect the effect of COVID-19 on lymphocyte and platelet parameters among Sudanese patients admitted to Intensive Care unit (ICU) and emergency (ER). PATIENTS AND METHODS: This cross-sectional study was carried out on a total of 787 Sudanese individuals (487 confirmed COVID-19 cases and 300 apparently healthy individuals as controls, in duration between April 2020 to December 2020). Platelets (PLTs) and platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and platelet larger cell ratio (PLCR) were investigated as part of the complete blood count (CBC) for the case and control group. Also, the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were calculated, and the results were statistically analyzed by SPSS version 21. RESULTS: The severity of the disease was also affected by the patient's age: 262 COVID-19 cases admitted to ICU were over 50 years old, compared to only four patients in the mild group. Regarding hematological parameters, the absolute lymphocyte count, PLTs, MPV, PDW, and P-LCR were significantly different between cases and control groups (p-values = 0.000, 0.002, 0.000, 0.000, and 0.000, respectively). PLR and NLR levels were found to be significantly higher as disease severity increased; p-values = 0.000 and 0.000, respectively. The study also demonstrated that lymphopenia was associated with severe COVID-19 infection (in 93% of ICU patients, 59.9% of ER, and 9% of the mild group), while thrombocytopenia was detected only among 30.8% of ICU patients. CONCLUSIONS: Lymphopenia and thrombocytopenia are associated with severe COVID-19 infection. NLR and PLR were markedly increased with COVID-19.