Journal
JOURNAL OF MEDICAL VIROLOGY
Volume 93, Issue 2, Pages 962-972Publisher
WILEY
DOI: 10.1002/jmv.26336
Keywords
coagulation dysfunction; coronavirus disease 2019; critically ill; meta-analysis; severe disease
Categories
Funding
- National Natural Science Foundation of China [81660132, 81960343]
- Emergency Science and Technology Brainstorm Project for the Prevention and Control of COVID-19, Guangxi Key Research and Development Plan [GuikeAB20058002]
- High-level Medical Expert Training Program of Guangxi139Plan Fund [G201903027]
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Coagulation dysfunction is common in severe COVID-19 patients and is associated with the severity of the disease. Patients who died had higher levels of D-dimer, longer prothrombin time, and lower platelet count compared to those who survived.
To systematically analyze the blood coagulation features of coronavirus disease 2019 (COVID-19) patients to provide a reference for clinical practice. An electronic search in PubMed, EMbase, Web of Science, Scopus, CNKI, WanFang Data, and VIP databases to identify studies describing the blood coagulation features of COVID-19 patients from 1 January 2020 to 21 April 2020. Three reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies, then, the meta-analysis was performed by using Stata 12.0 software. Thirty-four studies involving 6492 COVID-19 patients were included. Meta-analysis showed that patients with severe disease showed significantly lower platelet count (weighted mean differences [WMD]: -16.29 x 10(9)/L; 95% confidence interval [CI]: -25.34 to -7.23) and shorter activated partial thromboplastin time (WMD: -0.81 seconds; 95% CI: -1.94 to 0.33) but higher D-dimer levels (WMD: 0.44 mu g/mL; 95% CI: 0.29-0.58), higher fibrinogen levels (WMD: 0.51 g/L; 95% CI: 0.33-0.69) and longer prothrombin time (PT; WMD: 0.65 seconds; 95% CI: 0.44-0.86). Patients who died showed significantly higher D-dimer levels (WMD: 6.58 mu g/mL; 95% CI: 3.59-9.57), longer PT (WMD: 1.27 seconds; 95% CI: 0.49-2.06) and lower platelet count (WMD: -39.73 x 10(9)/L; 95% CI: -61.99 to -17.45) than patients who survived. Coagulation dysfunction is common in severe COVID-19 patients and it is associated with severity of COVID-19.
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