Analysis of Clotting Factors in Covid 19: A Study in Indian Patients in a Tertiary Hospital

Abstract

Coronavirus 2019(COVID 2019) is a global pandemic and may trigger coagulation dysfunction with extensive micro thrombosis. This study was conducted to evaluate the basic coagulation parameters in symptomatic patients with and without SARI in COVID.It was a prospective comparative cross sectional study to study the prognostic role of these markers in patients with and without SARI (severe acute respiratory illness) and survivors versus non survivors. Demographic characteristics , detailed medical history and platelets, prothrombin time (PT),activated thromboplastin time (APTT), fibrinogen and D dimer was recorded and analysed in both these groups. The independent group t-test and Mann -Whitney U test was used to analyse continuous variables. ROC was plotted for significant variables to obtain area under curve. The average PT for survivors was 14.6s and non survivors was 29.4s and the difference statistically significant. The area under curve for PT was 0.751 and at a cut off value of 13s had a sensitivity of 75% and specificity of 62.5% for predicting severe COVID with SARI. The median value for aPTT for non survivors was 35.5 (IQR 32.5-42.1) and for survivors it was 31.9 (IQR 29.5-35.7) and was significant. The mean values of D dimer for patients without and with SARI was 384 and 2168 mcg/ml and the difference was statistically significant (p=0.00). The D dimer test was the single most test distinguishing survivors and non survivors with an AUC of 0.844.The levels of fibrinogen and CRP was higher in patients with severe COVID and was statistically significant (p=0.001) and (p=0.028).The platelet count was lower in patients with severe COVID but difference was not statistically significant. The basic coagulation markers have a prognostic significance in treatment of COVID atients with and without SARIp.