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Indices of the Hemostasis System in Patients with COVID-19 Depending on the Outcome

E. Klychnikova1, S. Petrikov1, K. Popugaev1, E. Tazina1, S. Badygov1

1N.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentN.V. Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department, Moscow, Russian Federation

Abstract Number: PB0242

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: According to the literature, patients with COVID-19 who has been observed severe disorders in the hemostasis system more often had an unfavorable outcome.

Aims: To compare the indices of the hemostasis system in patients who had COVID-19 with favorable outcome and unfavorable outcome.

Methods: A prospective study of 122 patients (men was 53%, women was 47%) with a severe course of COVID-19 was carried out. The age was 59 ± 12 years. The patients’ condition, assessed by the NEWS and SOFA severity score, was 4.5 ± 1.4 and 6.1 ± 1.3 points, respectively. The patients were separated in 2 groups:
1 group (61 people) – “survivors”,
2 group (61 people) – “dead persons”.
The control group (norm) consisted of 20 apparently healthy donors. The research was performed on day 1 and 7 from the moment of admission to the hospital.

Results: The differences in APTT between two groups were no significant. The difference between two groups in PT’s values was significant on day1 and on day 7. The difference between two groups in FG’s level was significant on day 7. The difference between two groups in D-dimer’s level was significant both on day 1 and day 7 of the research. The difference between two groups of patients in the activity of AT III was significant on day 7. The difference between two groups of patients in the activity of Pr C was significant on day 1. The difference between two groups in platelet count was significant on day 7 (Table 1).

Index Day
1 7
“dead persons”, patients with unfavorable outcome (n = 61)
Prothrombin by Quick (PT), % 75.0 (65.0-84.5) * 81.0 (69.0-91.0) ●
Fibrinogen by Clauss (FG), g/l 4.91 (3.09-6.10) 5.17 (3.44-7.25) ●
D-dimer, mg/l 3.75 (1.01-6.66) * 3.23 (1.22-6.02) ●
Antithrombin III (AT III), % 94 (70-106) 85 (74-97) ●
Protein C (Pr C), % 90 (65-123) * 122 (100-191)
Platelet, 109/l 189.00 (108.00-256.00) 178.00 (128.00-269.00) ●
“survivors”, patients with favorable outcome (n = 61)
Prothrombin by Quick (PT), % 85.0 (71.0-92.9) 89.5 (82.3-99.0) *
Fibrinogen by Clauss (FG), g/l 4.98 (3.72-6.13) 3.88 (3.12-4.65) *
D-dimer, mg/l 0.49 (0.31-1.32) 0.67 (0.37-1.70)
Antithrombin III (AT III), % 98 (91-118) 102 (88-118)
Protein C (Pr C), % 106 (97-135) 131 (105-155) *
Platelet, 109/l 196.00 (153.75-273.50) 312.50 (236.00-390.00) *
Note: * p < 0.05 relative to the group of “Survivors, day 1”
● p < 0.05 relative to the group of “Survivors, day 7”
 

Indices of the hemostasis system in patients with COVID-19 depending on the outcome

Conclusions: In patients with a severe course of COVID-19 unfavorable factors in the development of the outcome were:
1. High level of D-dimer, decrease of PT and protein C on
day 1 of the study.
2. Decrease of platelet count and antithrombin III, increase of D-dimer and fibrinogen on day 7 after admission.

To cite this abstract in AMA style:

Klychnikova E, Petrikov S, Popugaev K, Tazina E, Badygov S. Indices of the Hemostasis System in Patients with COVID-19 Depending on the Outcome [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/indices-of-the-hemostasis-system-in-patients-with-covid-19-depending-on-the-outcome/. Accessed October 2, 2023.

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