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The effect of coagulation factors in 2019 novel coronavirus patients: A systematic review and meta-analysis.
Xiang, Guiling; Hao, Shengyu; Fu, Cuiping; Hu, Weiping; Xie, Liang; Wu, Qinhan; Li, Shanqun; Liu, Xuhui.
  • Xiang G; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China.
Medicine (Baltimore) ; 100(7): e24537, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1091184
ABSTRACT

BACKGROUND:

The role of coagulation dysfunction in Severe Coronavirus Disease 2019 (COVID-19) is inconsistent. We aimed to explore the impact of coagulation dysfunction amongst patients with COVID-19.

METHODS:

We searched PubMed, Cochrane and Embase databases from December 1, 2019 to April 27, 2020 following Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Data about coagulation (Platelets, PT, APTT, fibrin, fibrinogen degradation products, D-dimer), prevalence of coagulation dysfunction and mortality were extracted. Meta regression was used to explore the heterogeneity.

RESULTS:

Sixteen observational studies were included, comprising 2, 139 patients with confirmed COVID-19. More severe COVID-19 cases tended to have higher mean D-dimer (SMD 0.78, 95% CI 0.53 to 1.03, P < .001). The similar pattern occurred with PT and fibrin, with a contrary trend for PLTs. Coagulation dysfunction was more frequent in severe cases compared to less severe (SMD 0.46, 95% CI 0.25 to 0.67, P < .001). Higher mortality was associated with COVID-19-related coagulopathy (RR 10.86, 2.86 to 41.24, P < .001). Prevalence of ARDS was increased in more severe patients than less severe cases (RR 16.52, 11.27 to 24.22, P < .001). PT, fibrin and D-dimer levels elevated significantly in non-survivors during hospitalization.

CONCLUSION:

Presence of coagulation dysfunction might be associated with COVID-19 severity, and coagulopathy might be associated with mortality. Coagulation markers including PT, fibrin and D-dimer may imply the progression of COVID-19. This illuminates the necessity of effectively monitoring coagulation function for preventing COVID-19-related coagulopathy, especially in severe patients. For the obvious heterogeneity, the quality of the evidence is compromised. Future rigorous randomized controlled trials that assess the correlation between coagulation and COVID-19 are needed. TRIAL REGISTRATION PROSPERO (CRD42020183514).
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Coagulation Disorders / Blood Coagulation Factors / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article Affiliation country: Md.0000000000024537

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Blood Coagulation Disorders / Blood Coagulation Factors / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article Affiliation country: Md.0000000000024537