COVID-19 and coagulation parameters: a link to mortality?

The COVID-19 pandemic, caused by SARS-CoV-2, has led to millions of deaths worldwide. Among its major complications is an associated coagulopathy, characterized by hypercoagulation and thromboembolic disorders. These abnormalities, linked to an excessive inflammatory response, manifest as thromboses, pulmonary embolisms, or strokes, and represent a significant factor in the mortality of critically ill patients. This study aimed to establish the association between coagulation parameters and mortality in COVID-19 patients, highlighting potential biomarkers to assess risk and guide clinical care.

Which coagulation markers are associated with mortality?

A meta-analysis of 48 studies, including 6,969 participants, compared deceased patients to survivors. The main parameters analyzed included platelet count, prothrombin time (PT), D-dimer, INR, fibrinogen, and activated partial thromboplastin time (aPTT).

The results revealed significant thrombocytopenia in deceased patients, characterized by a lower average platelet count compared to survivors. Furthermore, levels of D-dimer, PT, and INR were significantly higher in deceased patients, indicating a hypercoagulable state. In contrast, fibrinogen and aPTT did not show significant differences between the two groups.

COVID-19 and coagulation parameters: a crucial link to mortality

This study emphasizes the critical role of coagulation parameters, such as D-dimer and PT, in assessing the severity and mortality risk in COVID-19 patients. Thrombocytopenia, already recognized as a marker of severity, is also confirmed as a reliable indicator of poor prognosis. These findings support the integration of systematic coagulation testing into clinical monitoring to quickly identify high-risk patients and optimize therapeutic strategies, particularly with anticoagulant use.