Dynamic changes in coagulation parameters and correlation with disease severity and mortality in patients with COVID-19

Objective: This study aimed to describe the dynamic changes of coagulation parameters and evaluate the relationship between longitudinal coagulation parameters abnormalities and prognosis of COVID-19 patients. Methods: We performed a retrospective study of 1131 COVID-19 patients. Longitudinal coagulation parameters and clinical outcomes were analyzed. Results: Abnormal coagulation parameters were observed in patients with COVID-19, both at hospital admission (INR 2.3%, PT 7.9%, APTT 15.4%, TT 0.9%, FDP 2.3%, D-dimer 19.7%) and peak hospitalization (INR 4.8%, PT 13.4%, APTT 25.6%, TT 2.7%, FDP 10.4%, D-dimer 31.5%). Compared with non-severe patients with COVID-19, severe patients had a slightly higher INR, PT, APTT, whereas remarkably higher FDP and D-dimer (p < 0.05). On multivariate analysis, age > 60 years, male, obesity, comorbidity, abnormal D-dimer on hospital admission, and abnormal peak hospitalization PT, APTT, FDP and D-dimer were associated with COVID-19 severity. The extreme coagulation parameters abnormalities (PT > 16s, FDP > 50 ug/ml, and D-dimer > 5 ug/ml) were associated with a significantly higher mortality. Conclusion: Longitudinal coagulation parameters abnormalities are common in patients with COVID-19, and associated with disease severity and mortality. Monitoring coagulation parameters is advisable to improve the management of patients with COVID-19.