Coagulation Profile and Outcomes of COVID-19 Patients at Wahidin Sudirohusodo Hospital, Makassar, Indonesia

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a viral pneumonia that spreads rapidly globally and was designated a pandemic by the World Health Organization (WHO). The number of cases has exceeded 15,000,000 worldwide, and the disease carries a mortality rate of ± 4%. One of the complications of COVID-19 is the incidence of coagulopathy and thromboembolism. The coronavirus (SARS-CoV-2) activates inflammatory and thrombotic processes, and the presence of coagulopathy and abnormal coagulation parameters is among the most significant biomarkers for poor prognosis in COVID-19 patients. COVID-19-associated coagulopathy is characterized by a decreased platelet count and the presence of a cytokine storm, indicating an extreme hypercoagulable state. AIM: This study aims to determine the coagulation profile and outcomes of patients with moderate-severe COVID-19. METHODS: This study was conducted in Wahidin Sudirohusodo Hospital. Medical record data were included for all inpatients diagnosed with COVID-19 using the RT-PCR test, from January 2021 to August 2021. The Kolmogorov– Smirnov normality test, Chi-squared test, odds ratio (OR), Mann–Whitney U-test, and independent t-test were used for statistical analysis. Multivariate analysis was carried out using the multiple logistic regression – backward Wald method. p < 0.05 was taken as statistically significant. RESULTS: A total of 231 patients with confirmed COVID-19 were included in this study. The mean prothrombin time (PT), D-dimer, and fibrinogen were higher in severe COVID-19 patients than in moderate patients and had significant results. Platelet (PLT) levels were not found to be significant in moderate-severe COVID-19. The relationship between groups of coagulation marker variables was found to be significantly associated with moderate-severe COVID-19. All coagulation markers were significantly related to patient outcome (p < 0.05). The mean value of each variable was found to be higher in patients who died than in those with better outcomes. CONCLUSION: An increase in PT, activated partial thromboplastin time (APTT), and fibrinogen is associated with mortality in patients with moderate COVID-19. In patients with severe COVID-19, mortality is associated with increased PT. PT is, therefore, a coagulation marker that is significantly related to COVID-19 outcome.