Evaluation of Coagulation Marker Frequency and Their Relationship with Disease Severity in COVID-19 Patients

Subject Areas :

Ahmad Ghader ¹ , Latife Jabbari ² , Nahid Zamani Mehr ³ , Kourosh Akhbari ⁴ , Darab Zohri ⁵ , Ahmad Moradi ⁶

1 - Kurdestan Medical Sciences Surgery Resident, Kurdestan Univercsty of Medical Sciences, Sanandaj, Iran
2 - Department of Emergency Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3 - Department of Emergency Medicine, Faculty of Medicine, Kurdestan Univercsty of Medical Sciences, Sanandaj, Iran
4 - Department of Emergency Medicine, Kosar Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
5 - Department of Emergency Medicine, Faculty of Medicine, Kurdestan Univercsty of Medical Sciences, Sanandaj, Iran
6 - ایران

Received: 2024-10-28 Accepted : 2025-02-10 Published : 2025-07-31

Keywords: Virus, Covid-19, Coagulation markers, D-dimer, Disease severity, Prothrombin time, ,

Abstract :

COVID-19 has been shown to significantly impact the body's coagulation system, leading to various blood clotting abnormalities. This study aimed to assess the frequency of coagulation markers and their correlation with disease severity in COVID-19 patients admitted to Towhid Hospital in Sanandaj in 2021.In this cross-sectional, descriptive-analytical study, data from 300 COVID-19 patients were analyzed. Blood samples were collected upon hospital admission, with results documented in patient records. The study examined coagulation test results, including age, gender, D-dimer levels, aPTT, INR, and prothrombin time, and explored their relationship with disease severity indicators such as hospital stay duration, ICU admission, and mortality. Statistical analyses were performed using Stata software, with a significance threshold set at 0.05.Of the participants, 55% were male, and 45% were female. Patients under the age of 30 accounted for 17.33% of the cohort (the smallest group), while those over 60 comprised 50.33% (the largest group). Additionally, 52.33% of the participants had pre-existing conditions. ICU admission was required for 19% of the patients, and the mortality rate was 12%. The average length of hospital stay was 7.04 days (SD = 5.06 days). T-test analyses showed significant associations between elevated D-dimer levels and ICU admission, increased D-dimer and aPTT levels with mortality, and higher aPTT levels in patients with underlying conditions (P < 0.0001). COVID-19 appears to have a significant impact on the hematologic system, often presenting with leukopenia, lymphopenia, thrombocytopenia, and a hypercoagulable state. Close monitoring of coagulation markers throughout the clinical course can help healthcare providers identify patients at higher risk of complications. Given the increased coagulability and hematologic abnormalities observed in these patients, physicians should promptly initiate appropriate interventions, such as anticoagulant therapy, to prevent thromboembolic events and improve patient outcomes.

References:

References:

1. Karimi M., Gholami-Ahangaran M., 2021. A brief report on current evidence of traditional Chinese medicine in the treatment of patients infected with SARS-CoV-2. Plant Biotechnol Persa. 3(1), 34-36. doi: 10.52547/pbp.3.1.1.
2. Pirhadi M., 2023. Investigating the role of medicinal plants in reducing stress caused by COVID-19. J Biochem Phytomed. 2(2), 91-93. doi: 10.34172/jbp.2023.19.
3. Widoyo H., Mohammed Z.Y., Ramírez-Coronel A.A., Iswanto A.H., Thattarauthodiyil U., Alkhayyat A.S., Karimi M., Bahmani M., Eftekhari Z., 2023. Herbal therapy in COVID-19: A systematic review of medicinal plants effective against COVID-19. Caspian J Environ Sci. 21(5), 1289-1298. doi: 10.22124/cjes.2023.7431.
4. Alomar T., Baig M.R., Anbar H.S., 2024. Post COVID vaccination experience among the United Arab Emirates general public. J Chem Health Risks. 1, 14(2), 319 – 329.
5. Alhemiary H., Almayoof D., 2022. Usage of phenytoin in treatment of severe headache in COVID-19 patients. J Chem Health Risks. 1, 9(3), 5.
6. Najafipour R., Mohammadi D., Momeni M., Moghbelinejad S., 2022. ACE-2 expression and methylation pattern in bronchoalveolar lavage fluid and blood of Iranian ARDS COVID-19 patients. Int J Mol Cell Med. 11(1), 55-63.
7. Thachil J., Tang N., Gando S., Falanga A., Cattaneo M., Levi M., Clark C., Iba T., 2020. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 18(5), 1023.
8. Hulswit R.J., de Haan C.A., Bosch BJ., 2016. Coronavirus spike protein and tropism changes. Adv Virus Res. 96, 29-57.
9. Iba T., Levy J.H., Wada H., Thachil J., Warkentin T.E., Levi M., 2019. Subcommittee on disseminated intravascular coagulation. Differential diagnoses for sepsis-induced disseminated intravascular coagulation: communication from the ISTH. J Thromb Haemost. 17(2), 415-419.
10. Sherida F.J., Woei-A-Jin H.W., van der Starre W.E., Tesselaar M.E., Garcia Rodriguez P., van Nieuwkoop C., Bertina R. M., van Dissel J.T., Osanto S., 2014. Procoagulant tissue factor activity on microparticles is associated with disease intensity and bacteremia in febrile urinary tract infections. Thromb Res. 133(5),799-803.
11. Daly M., Robinson E., 2022. Depression and anxiety during COVID-19. The Lancet. 399(10324), 518.
12. Tang N., Bai H., Chen X., Gong J., Li D., Sun Z., 2020, Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 18(5), 1094-1099.
13. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., Guan L., Wei Y., Li H., Wu X., Xu J., Tu S., Zhang Y., Chen H., Cao B., 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 395(10229), 1054-1062.
14. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., Wang B., Xiang H., Cheng Z., Xiong Y., Zhao Y., Li Y., Wang X., Peng Z., 2020. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 323(11), 1061-1069.
15. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., Guan L., Wei Y., Li H., Wu X., Xu J., Tu S., Zhang Y., Chen H., Cao B., 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.395(10229), 1054-1062.
16. Darvishi M., Ziari K., Mohebi H., Alizadeh K., 2015. Association between iron deficiency anemia and Helicobacter pylori infection among children under six years in Iran.‏ Acta Medica Iranica. 53(4), 1-7.
17. Forootan M., Tabatabaeefar M., Mosaffa N., Ashkalak H.R., Darvishi M., 2018. Investigating esophageal stent-placement outcomes in patients with inoperable non-cervical esophageal cancer. J Cancer. 9(1), 213.
18. Mussavi M., Asadollahi K., Janbaz F., Mansoori E., Abbasi N., 2014. The evaluation of red reflex sensitivity and specificity test among neonates in different conditions. Iranian J Pediat. 24(6), 697.
19. Darvishi M., Nazer M.R., Alipour M.R., 2017. Investigating the end of patients suffering from diabetic foot hospitalized in Be'sat hospital of IRIAF from 2009 to 2014. Biomed Res India. 28, 4630-4633.
20. Mahmoudvand H., Badparva E., Khalaf A.K., Niazi M., Khatami M., Nazer M.R., 2020. Prevalence and associated risk factors of intestinal helminthic infections in children from Lorestan province, Western Iran. Parasite Epidemiol Control. 9, e00136.
21. Raoofi R., Nazer M.R., Pournia Y., 2012. Seroepidemiology of hepatitis E virus in Western Iran. Braz J Infect Dis. 16, 302-303.
22. Darvishi M., 2016. Antibiotic resistance pattern of uropathogenic methicillin-resistant Staphylococcus aureus isolated from immunosuppressive patients with pyelonephritis. J Pure Appl Microbiol. 10(4), 2663-2667.
23. Salarvand S., Nazer M.R., Shokri S., Bazhvan S., Pournia Y., 2012. Brucellosis-induced avascular necrosis of the hip in a middle-aged person. Iranian J Public Health. 41(12), 86.
24. Buoninfante A., Andeweg A., Genov G., Cavaleri M., 2024. Myocarditis associated with COVID-19 vaccination. npj Vaccines. 9(1), 122.
25. Sulandjari K., Putra A., Sulaminingsih S., Cakranegara P., Yusroni N., Andiyan A., 2022. Agricultural extension in the context of the COVID-19 pandemic: Issues and challenges in the field. Caspian J EnvironSci. 20(1), 137-143. doi: 10.22124/cjes.2022.5408.
26. Vakili S., Rostami A., Namavar Jahromi B., Jafarinia M., 2024. Changes in inflammatory cytokines, vascular markers, cell cycle regulators, and gonadotropin receptors in granulosa cells of COVID-19 infected women: Gene expression analysis in granulosa cells of COVID-19 infected women. Galen Med J. 13, e3625. doi: 10.31661/gmj.v13i.3625.
27. Hassanzadeh Khanmiri H., Mohammad A.A., Yousif R.S., Jasim S.A., Kzar H.H., Lafta M.H., Jalil A.T., Romero Parra R.M., Darvishi M., 2023. SARS-CoV2 neuroinvasive potential in respiratory failure in COVID-19 patients. Caspian J Environ Sci. 21(2), 467-472. doi: 10.22124/cjes.2023.6635.
28. Najafipour R., Mohammadi D., Momeni M., Moghbelinejad S., 2022. ACE-2 expression and methylation pattern in bronchoalveolar lavage fluid and blood of Iranian ARDS COVID-19 patients. Int J Mol Cell Med. 11(1), 55-63.
29. Pellokila M.R., Nendissa D.R., Kapa M.M.J., Sui J.M., Elbaa E.F., Kana Y.R., Elim Y.V., Lerik MD., 2023. Environmental challenges due to COVID-19: Implications of altered distribution patterns and rice price dynamics in surplus and deficit areas of Indonesia. Caspian J Environ Sci. 21(5), 1159-1170. doi: 10.22124/cjes.2023.7406.
30. Haddadzadeh Shoushtari M., Raji H., Borsi S.H., Tavakol H., Cheraghian B., Moeinpour M., 2024. Evaluating the therapeutic effect of sofos buvir in outpatients with COVID-19: A randomized clinical trial study. Galen Med J. 13, e3035. doi: 10.31661/gmj.v13i.3035.
31. Alhemiary H., Almayoof D., 2022. Usage of phenytoin in treatment of severe headache in COVID-19 patients. J Chem Health Risks. 20(4), 635-640. doi: 10.22034/jchr.2022.690506.
32. Khadom A.A., Khudhair Al-Jiboory A., Mahdi S., Mahood B., 2021. Regression and validation studies of the spread of novel COVID-19 in Iraq using mathematical and dynamic neural networks models: A case of the first six months of 2020. Caspian J Environ Sci. 19(3), 431-440. doi: 10.22124/cjes.2021.4930.
33. Sills E.S., Wood S.H., 2020. An experimental model for peri-conceptual COVID-19 pregnancy loss and proposed interventions to optimize outcomes. Int J Mol Cell Med. 9(3), 180-187.
34. Al-Awade H.A.R., 2022. Effect of smoking on infection with COVID-19. Caspian Journal of Environmental Sciences. 20(2), 407-411. doi: 10.22124/cjes.2022.5588.
35. Mohammadian Amiri M., Dastyar N., Khajoei Nejad F., Ahmadi M., Piri N., Manouchehri A., Shokri S., 2022. The outbreak of post-traumatic stress disturbances during the COVID-19 pandemic: A systematic review. Caspian J Environ Sci. 20(5), 1149-1157. doi: 10.22124/cjes.2022.6096.
36. Naumenko O.M., Moyseyenko V.O., 2021. Trace element imbalance in patients with combined digestive and renal pathology complicated with COVID-19. J Chem Health Risks. 19(3), 431-435. doi: 10.22034/jchr.2021.686477.

Home Site Map Islamic Azad University