Covid-19: Consumption coagulopathy with increased severity and mortality - A retrospective study

To compare quantitative values of parameters of coagulation pathway like Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), International Normalized Ratio (INR) and D-Dimer (DD) on date of admission versus date of patient's mortality. A total of 50 patients who were tested positive for COVID-19 in our hospital between April 21, 2021 and May 30, 2021, were taken into this study. The changes in PT, APTT, INR and DD were compared at day of admission and day of patient's mortality. The study involved 50 patients (36 male and 14 female). D-dimer at the day of admission (mean 1540.79 ng/ml; IQR 231-8776) was found with an elevation of 250% at the day of mortality (mean 5379.04ng/ml; IQR 434-10000). PT at the day of admission (mean 13.602; IQR 11.6-14.8) was found elevated (Normal range-10.5-13.5sec) in 19/50 patients which increased to 43/50 patients at the day of mortality, an increase of 126%. According to the study done, the number of patients with increased levels of PT, APTT, INR and DD were substantially greater at the time of mortality compared to the same patients at their time of admission, suggesting a dynamic coagulation process in COVID-19 patients. This likely suggested that the patients were in progression from a hypercoagulating state that transforms into a fibrinolytic state as a result of the extensive use of coagulation factors.