A Retrospective analysis of DIC score and SIC score in prediction of COVID-19 severity (preprint)

ABSTRACT

Background: The novel Disseminated Intravascular Coagulation (DIC) score [platelet count, prolonged prothrombin time, D-dimer, and fibrinogen] and Sepsis Induced Coagulopathy (SIC) score [platelet count, International normalized ratio, and Sequential organ failure assessment score] are markers of coagulopathy, which, for the first time, are explored in line with the COVID-19 disease outcomes. The correlation of D-dimer with these findings is also studied. Patients and methods: A retrospective analysis of hospital-based records of 168 COVID-19 patients. Data including D-dimer, routine investigations, DIC and SIC scorings (all within three days of admission) were collected and correlated with the outcomes. The study was conducted in a tertiary care center catering to population of North India. Results: Higher DIC score (1{middle dot}59 {+/-} 1{middle dot}18 v/s 0{middle dot}96 {+/-} 1{middle dot}18), SIC score (1{middle dot}60 {+/-} 0{middle dot}89 v/s 0{middle dot}63 {+/-} 0{middle dot}99), and D-dimer titers (1321{middle dot}33 {+/-} 1627{middle dot}89 v/s 583{middle dot}66 {+/-} 777{middle dot}71 ng/ml) were significantly associated with severe COVID-19 disease (P<0{middle dot}05). DIC score and SIC score [≥] 1, and D-dimer [≥] 1315 ng/ml for severe disease; DIC score [≥] 1, SIC score [≥] 2, and D-dimer [≥] 600 ng/ml for Pulmonary Embolism (PE); and DIC score and SIC score [≥] 1, and D-dimer level [≥] 990 ng/ml for mortality were the respective cut-off values we found from our study. Conclusion: Higher DIC scores, SIC scores, and D-dimer values are associated with severe COVID-19 disease, in-hospital mortality, and PE risk. They can serve as easily accessible early markers of severe disease and prioritize hospital admissions in the presently overburdened scenario, and may be used to develop prognostic prediction models.