Implications of COVID-19 on Thrombotic Profile of Severely Affected Patients

Pathobiology. 2022;89(6):407-417. doi: 10.1159/000522543. Epub 2022 Mar 28.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a novel viral disease that spread as a global pandemic in 2020 by infecting millions of people across the world. Its clinical prognosis is dependent on various coagulatory parameters since thrombotic events are frequently associated with infection severity.

Methods: A total of 383 COVID-19 patients enrolled in Rajiv Gandhi Super Specialty Hospital, Delhi, India, were included in the present retrospective study. Patients were divided into three categories, severe (n = 141), moderate (n = 138), and mild (n = 104) based on infection severity. Various thrombotic parameters and anticoagulant levels were measured in 70 patients and further analyzed.

Results: Coagulopathy is seen in COVID-19 patients (n = 70) with a significant increase in fibrinogen, D-dimer levels, and prothrombin time in patients with severe and moderate disease compared to patients with a mild infection. Approximately, 70% of patients with severe and moderate disease demonstrated fibrinogen levels higher than the standard reference range. 60.41% of patients with severe disease showed significantly higher D-dimer levels. Thrombotic parameters were notably elevated in the nonsurvivors group compared to COVID-19 survivors. Nearly, 91% of patients with severe infection had anticoagulant protein S levels below the reference range.

Conclusion: COVID-19 infection severely impacts the blood coagulation cascade, which might lead to the manifestation of severe symptoms and increased mortality in patients.

Keywords: Coronavirus disease 2019; D-dimer; Fibrinogen; Indian population; Severe acute respiratory syndrome coronavirus 2; Thrombosis.

MeSH terms

  • Anticoagulants / therapeutic use
  • COVID-19* / complications
  • Fibrinogen
  • Humans
  • Retrospective Studies
  • SARS-CoV-2
  • Thrombosis* / etiology

Substances

  • Anticoagulants
  • Fibrinogen

Grants and funding

The authors have received funding for this work from Defence Institute of Physiology and Allied Sciences, DRDO.