The Association Between Mortality Due to COVID-19 and Coagulative Parameters: a Systematic Review and Meta-analysis Study

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2024 Dec 2

PMID 39623325

Authors

Alireza Abdollahi

Saeed Nateghi

Zahra Panahi

Seyed Hassan Inanloo

Samaneh Salarvand

Seyed Morteza Pourfaraji

Affiliations

Soon will be listed here.

Abstract

Aims And Objectives: This systematic review and meta-analysis study evaluated the association between mortality due to COVID-19 and coagulative factors.

Methods: A systematic search was conducted on electronic databases including PubMed, Scopus, and the Web of Science from the beginning of the pandemic until October 2024 to identify relevant studies on COVID-19 patients and their laboratory findings related to coagulation markers and mortality outcome. Eligibility criteria were defined based on the PICO framework, and data extraction was performed by two authors independently using a standardized sheet. Statistical analysis was accomplished using the random effects model, and heterogeneity among studies was assessed using the I test. R and RStudio were used for statistical analysis and visualization.

Results: Our systematic literature search yielded 6969 studies, with 48 studies meeting the inclusion criteria for our meta-analysis. The mean platelet count was significantly lower in deceased COVID-19 patients compared to survivors (20.58), while activated partial thromboplastin time (aPTT) and fibrinogen levels did not show significant differences. The pooled mean difference of D-Dimer, International Normalized Ratio (INR), and prothrombin time (PT) were significantly lower in survived patients (-2.45, -0.10, and -0.84, respectively). These findings suggest that platelet count, D-Dimer, INR, and PT may serve as potential indicators of mortality in COVID-19 patients.

Conclusion: The results of our systematic review and meta-analysis revealed a significant reduction in the pooled platelet count among deceased individuals when compared to survivors. However, no significant distinctions were observed in the pooled mean activated aPTT and fibrinogen levels between the deceased and survivor groups. On the other hand, there were noticeable variations in the pooled estimated mean of INR, PT, and D-Dimer levels, with significantly higher values in the deceased group compared to those who survived.

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References

Fanning J, Weaver N, Fanning R, Griffee M, Cho S, Panigada M . Hemorrhage, Disseminated Intravascular Coagulopathy, and Thrombosis Complications Among Critically Ill Patients with COVID-19: An International COVID-19 Critical Care Consortium Study. Crit Care Med. 2023; 51(5):619-631. PMC: 10089926. DOI: 10.1097/CCM.0000000000005798. View

Malkoc A, GnanaDev R, Botea L, Jeney A, Glover K, Retamozo M . A Comparative Analysis of Critical Limb Ischemia in the Intensive Care Unit since the COVID-19 Pandemic. Ann Vasc Surg. 2022; 90:39-47. PMC: 9722237. DOI: 10.1016/j.avsg.2022.11.001. View

Krinsky N, Sizikov S, Nissim S, Dror A, Sas A, Prinz H . NETosis induction reflects COVID-19 severity and long COVID: insights from a 2-center patient cohort study in Israel. J Thromb Haemost. 2023; 21(9):2569-2584. PMC: 10088279. DOI: 10.1016/j.jtha.2023.02.033. View

Antoniello A, Brophy A, Opsha Y . Evaluation of Hospitalized Patient Outcomes in COVID-19 Infection for Continued versus Discontinued Use of Preadmission Antiplatelet Regimen. J Pharm Pract. 2021; 36(3):508-513. PMC: 10189532. DOI: 10.1177/08971900211053294. View

Siavoshi F, Safavi-Naini S, Shirzadeh Barough S, Azizmohammad Looha M, Hatamabadi H, Ommi D . On-admission and dynamic trend of laboratory profiles as prognostic biomarkers in COVID-19 inpatients. Sci Rep. 2023; 13(1):6993. PMC: 10144885. DOI: 10.1038/s41598-023-34166-z. View

Lin J, Yan H, Chen H, He C, Lin C, He H . COVID-19 and coagulation dysfunction in adults: A systematic review and meta-analysis. J Med Virol. 2020; 93(2):934-944. PMC: 7405098. DOI: 10.1002/jmv.26346. View

Sofi-Mahmudi A, Masinaei M, Shamsoddin E, Tovani-Palone M, Heydari M, Shoaee S . Global, regional, and national burden and quality of care index (QCI) of lip and oral cavity cancer: a systematic analysis of the Global Burden of Disease Study 1990-2017. BMC Oral Health. 2021; 21(1):558. PMC: 8561915. DOI: 10.1186/s12903-021-01918-0. View

Wang H, Sun B, Li X, Wang Y, Yang Z . Clinical analysis of severe COVID-19 patients. Technol Health Care. 2022; 30(S1):225-234. PMC: 9028659. DOI: 10.3233/THC-228021. View

Balshem H, Helfand M, Schunemann H, Oxman A, Kunz R, Brozek J . GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011; 64(4):401-6. DOI: 10.1016/j.jclinepi.2010.07.015. View

10.

Bolek T, Samos M, Jurica J, Stanciakova L, Pec M, Skornova I . COVID-19 and the Response to Antiplatelet Therapy. J Clin Med. 2023; 12(5). PMC: 10004309. DOI: 10.3390/jcm12052038. View

11.

Zhu A, Zakusilo G, Lee M, Kim J, Kim H, Ying X . Laboratory parameters and outcomes in hospitalized adults with COVID-19: a scoping review. Infection. 2021; 50(1):1-9. PMC: 8272607. DOI: 10.1007/s15010-021-01659-w. View

12.

Citu C, Burlea B, Gorun F, Motoc A, Gorun O, Malita D . Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania. J Clin Med. 2022; 11(10). PMC: 9146890. DOI: 10.3390/jcm11102831. View

13.

Poskurica M, Stevanovic D, Zdravkovic V, Cekerevac I, Cupurdija V, Zdravkovic N . Admission Predictors of Mortality in Hospitalized COVID-19 Patients-A Serbian Cohort Study. J Clin Med. 2022; 11(20). PMC: 9605560. DOI: 10.3390/jcm11206109. View

14.

McHugh M . Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012; 22(3):276-82. PMC: 3900052. View

15.

Girard T, Antunes L, Zhang N, Amrute J, Subramanian R, Eldem I . Peripheral blood mononuclear cell tissue factor (F3 gene) transcript levels and circulating extracellular vesicles are elevated in severe coronavirus 2019 (COVID-19) disease. J Thromb Haemost. 2023; 21(3):629-638. PMC: 9773443. DOI: 10.1016/j.jtha.2022.11.033. View

16.

Teimury A, Khameneh M, Mahmoodi Khaledi E . Major coagulation disorders and parameters in COVID-19 patients. Eur J Med Res. 2022; 27(1):25. PMC: 8845229. DOI: 10.1186/s40001-022-00655-6. View

17.

Aliani C, Rossi E, Luchini M, Calamai I, Deodati R, Spina R . Automatic COVID-19 severity assessment from HRV. Sci Rep. 2023; 13(1):1713. PMC: 9887241. DOI: 10.1038/s41598-023-28681-2. View

18.

Khreefa Z, Barbier M, Koksal A, Love G, Del Valle L . Pathogenesis and Mechanisms of SARS-CoV-2 Infection in the Intestine, Liver, and Pancreas. Cells. 2023; 12(2). PMC: 9856332. DOI: 10.3390/cells12020262. View

19.

Yoo E, Chang S, Song D, Lee C, Cheong G, Park S . Comprehensive Laboratory Data Analysis to Predict the Clinical Severity of Coronavirus Disease 2019 in 1,952 Patients in Daegu, Korea. Ann Lab Med. 2021; 42(1):24-35. PMC: 8368228. DOI: 10.3343/alm.2022.42.1.24. View

20.

Easwaran V, Satarker S, V Gujaran T, John J, Veedu A, George K . Expediting Molecular Translational Approach of Mesenchymal Stem Cells in COVID-19 Treatment. Curr Stem Cell Res Ther. 2022; 18(5):653-675. DOI: 10.2174/1574888X18666221124122113. View