Association of Coagulation Disorder with the Severity and Mortality of Coronavirus Disease 2019 (COVID-19): A Meta-Analysis
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i2.4039
Abstract
Background: Coronavirus disease 2019 (COVID-19) , a significant health concern in recent years, is known for its multiple complications. Coagulation disorder is a prevalent complication among patients with COVID-19, but the association of coagulation disorder with the severity and mortality of COVID-19 is still unclear. The object of this study is to ascertain the potential association between coagulation disorder and severity and mortality of COVID-19. Methods: We conducted a systemic literature search of the CNKI, PubMed, Cochrane Library,and Web of Science databases for all relevant studies up to October 1, 2024. All the articles published were retrieved without language restriction. Meta-analysis were performed by Stata 18.0 software. The Newcastle Ottawa scale was used to assess the quality of the included studies. The funnel plot, Egger’s regression asymmetry test, and Begg’s test used to measure the bias of publications. Results: Eighteen studies comprising 2,577 COVID-19 patients were included. Six studies was associated with the mortality of COVID-19, indicating significant differences in DD (SMD: 0.81, 95% confidence interval [CI](0.48-1.14), P=0.02, I2=63.82%); APTT (SMD: 0.37, 95% confidence interval [CI](-0.12-0.86), P=0.14, I2=86.85%); PT (SMD: 0.74, 95% confidence interval [CI](0.34-1.15), P=0.00, I2=70.28%) . Twelve studies was associated with the severity of COVID-19, indicating significant differences in DD (SMD: 1.39, 95% confidence interval [CI](0.93-1.86), P=0.00, I2=93.49%); FIB (SMD: 0.63, 95% confidence interval [CI](0.30-0.96), P=0.00, I2=86.32%); PT (SMD: 0.43, 95% confidence interval [CI](0.12-0.74), P=0.01, I2=82.73%) . Conclusions: The findings confirm that coagulation disorder is associated with severity and mortality of COVID-19. Therefore, it is imperative to monitor blood coagulation indicator and administer treatments in COVID-19 to reduce the severity and mortality.
Keywords
Coagulation disorder; COVID-19; SARS-CoV-2, Severity, Mortality
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[1]Zhang Yuping, Zhang Limin & Zhao Zigang. (2021). Mechanism and treatment strategies of coagulation disorders in patients with novel coronavirus pneumonia. Journal of Practical Shock (02), 68-71.
[2]Rostami M, Khoshnegah Z, Mansouritorghabeh H. Hemostatic System (Fibrinogen Level, D-Dimer, and FDP) in Severe and Non-Severe Patients With COVID-19: A Systematic Review and Meta-Analysis. Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211010973.
[3]Liberati A, Altman DG, Tetzlaff J. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-34
[4]Li, Zhi-Yu, et al. "Guidelines on the treatment with integrated traditional Chinese medicine and western medicine for severe coronavirus disease 2019." Pharmacological Research 174 (2021): 105955.
[5]Qiu Xuan, Zhang Yao, Lin Lizhong, et al.Analysis of laboratory indicators of 82 patients with novel coronavirus pneumonia in Changde City[J].China Medical Engineering,2022,30(12):71-77.
[6]Guo Wenjuan, Hu Xue, Dai Jie, et al. Study on the relationship between laboratory examination indicators and the severity of disease in patients with new coronary pneumonia[J].China Medical Engineering,2022,30(10):117-119.
[7]Conan Tian, Guo Yanfen, Gong Yanyuan, et al. Medical Theory & Practice,2023,36(13):2271-2273.
[8]Zhong Changli, Zhang Benrong, Zhang Wenlong, et al. Clinical value of thromboelastography in evaluating coagulation function in patients with novel coronavirus pneumonia[J].Chinese Journal of Blood Transfusion,2021,34(08):864-867.
[9]Duan Jinxia, Yan Bin, Sun Xiao, et al. The diagnostic value of blood routine and coagulation routine detection in severe novel coronavirus pneumonia[J].Laboratory Medicine and Clinical Medicine,2022,19(02):168-171.)
[10]Wang Xiaowu, Gao Yong, Wu Dong. The predictive value of coagulation indexes on the development of COVID-19[J].Laboratory Medicine,2021,36(01):57-59.
[11]Wang L, Liu T, Yue H, Zhang J, Sheng Q, Wu L, Wang X, Zhang M, Wang J, Wang J, Yu W. Clinical characteristics and high risk factors of patients with Omicron variant strain infection in Hebei, China. Front Cell Infect Microbiol. 2023 Dec 1;13:1294904.
[12]Esmaeel HM, Ahmed HA, Elbadry MI, Khalaf AR, Mohammed NA, Mahmoud HA, Taha EM. Coagulation parameters abnormalities and their relation to clinical outcomes in hospitalized and severe COVID-19 patients: prospective study. Sci Rep. 2022 Aug 1;12(1):13155.
[13]Yang T, Liu LL, Wu XH, Xue JG, He CY. Serum hyaluronic acid and procollagen III, N-terminal propeptide levels are highly associated with disease severity and predict the progression of COVID-19. Front Cell Infect Microbiol. 2023 Oct 4;13:1249038.
[14]Feng S, Wang F, Wu W, Li Y, Chen C, Li J, Cao M, Peng L, Zhang P, Wang F. Analysis of multiple organ function damage in patients with severe COVID-19 pneumonia. J Med Biochem. 2023 Aug 25;42(3):444-453.
[15]Chen X, Wang Q, Xu M, Li C. A Retrospective Analysis of the Coagulation Dysfunction in COVID-19 Patients. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620964868.
[16]Zou Y, Guo H, Zhang Y, Zhang Z, Liu Y, Wang J, Lu H, Qian Z. Analysis of coagulation parameters in patients with COVID-19 in Shanghai, China. Biosci Trends. 2020 Sep 21;14(4):285-289.
[17]Clinical value of combination of Chest CT pulmonary inflammation index,lactic acid and NLR in prognosis of COVID-19 pneumonia.
[18]Martín-Rojas RM, Chasco-Ganuza M, Casanova-Prieto S, Delgado-Pinos VE, Pérez-Rus G, Duque-González P, Sancho M, Díez-Martín JL, Pascual-Izquierdo C. A mild deficiency of ADAMTS13 is associated with severity in COVID-19: comparison of the coagulation profile in critically and noncritically ill patients. Blood Coagul Fibrinolysis. 2021 Oct 1;32(7):458-467.
[19]Rasyid A, Riyanto DL, Harris S, Kurniawan M, Mesiano T, Hidayat R, Wiyarta E. Association of coagulation factors profile with clinical outcome in patient with COVID-19 and acute stroke: A second wave cohort study. Clin Hemorheol Microcirc. 2022;82(4):371-377.
[20]Binsaleh NK, Eltayeb R, Sherwani S, Almishaal AA, Hindi EA, Qanash H, Bazaid AS, Alharbi AO, Bazaid MB, Altamimi SA. Comparison of Hematological Parameters Between Survivors and Non-Survivors COVID-19 Patients in Saudi Arabia. Int J Gen Med. 2023 Aug 31;16:3955-3962.
[21]Zhu H, Li Y, Su H, Yan C, Xin W, Ying K. What Is the Impact of Baseline Inflammatory and Hemostatic Indicators with the Risk of Mortality in Severe Inpatients with COVID-19: A Retrospective Study. Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241255959.
[22]Wei S, Xiaqin W, Liwei L, Fasu Z, Ying P, Pingping T, Furong Y. Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China. Cureus. 2024 May 10;16(5):e60069.
[23]Wu Jiao, Wang Peichun, Liu Xuan. Coagulation dysfunction in patients with novel coronavirus pneumonia and its possible mechanisms and treatment strategies[J].Journal of Shanghai University of Traditional Chinese Medicine,2022,36(06):90-100.
[24]Wu Di, Fan Xinxin, Shen Jianshan, et al. The diagnostic value of coagulation screening indexes and D-dimer in clinical classification of patients with novel coronavirus pneumonia[J].Journal of Tuberculosis and Lung Diseases,2021,2(04):355-360.
[25]Chen Huijuan, Chen Lijuan, Wei Shuo. Clinical characteristics and coagulation function analysis of patients infected with novel coronavirus Delta variant[J].Medical Theory & Practice,2022,35(22):3796-3798+3791.
[26]Guevara-Noriega KA, Lucar-Lopez GA, Nuñez G, Rivera-Aguasvivas L, Chauhan I. Coagulation Panel in Patients with SARS-CoV2 Infection (COVID-19). Ann Clin Lab Sci. 2020 May;50(3):295-298.
[27]Fu, Z. X., Huang, J., Wang, C. Z., Tang, X. A., & Deng, M. F. (2021). Preliminary study on the differential value of coagulation indexes and D-dimer level in the clinical classification of COVID-19 patient.
[28]Jin Y ,Cai L ,Cheng Z , et al.A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)[J].Military Medical Research,2020,7(01):1-22.
[29]on Prevention, National Cooperation Group. "Practice guidelines of thromboprophylaxis and management of anticoagulation in hospitalized patients with COVID-19." Zhonghua yi xue za zhi 103.12 (2023): 863-885.
[30]Zhan, Yang-Qing, et al. "Efficacy and safety of Lianhua Qingwen capsules combined with standard of care in the treatment of adult patients with mild to moderate COVID-19 (FLOSAN): protocol for a randomized, double-blind, international multicenter clinical trial." Journal of Thoracic Disease 15.5 (2023): 2859.
[31]Zhou Li, Qin Chuan.2019 Novel Coronavirus Pneumonia Coagulation Abnormal Mechanism and Traditional Chinese Medicine Blood Stasis Syndrome[J].China Journal of Comparative Medicine,2022,32(01):89-96.
[2]Rostami M, Khoshnegah Z, Mansouritorghabeh H. Hemostatic System (Fibrinogen Level, D-Dimer, and FDP) in Severe and Non-Severe Patients With COVID-19: A Systematic Review and Meta-Analysis. Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211010973.
[3]Liberati A, Altman DG, Tetzlaff J. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-34
[4]Li, Zhi-Yu, et al. "Guidelines on the treatment with integrated traditional Chinese medicine and western medicine for severe coronavirus disease 2019." Pharmacological Research 174 (2021): 105955.
[5]Qiu Xuan, Zhang Yao, Lin Lizhong, et al.Analysis of laboratory indicators of 82 patients with novel coronavirus pneumonia in Changde City[J].China Medical Engineering,2022,30(12):71-77.
[6]Guo Wenjuan, Hu Xue, Dai Jie, et al. Study on the relationship between laboratory examination indicators and the severity of disease in patients with new coronary pneumonia[J].China Medical Engineering,2022,30(10):117-119.
[7]Conan Tian, Guo Yanfen, Gong Yanyuan, et al. Medical Theory & Practice,2023,36(13):2271-2273.
[8]Zhong Changli, Zhang Benrong, Zhang Wenlong, et al. Clinical value of thromboelastography in evaluating coagulation function in patients with novel coronavirus pneumonia[J].Chinese Journal of Blood Transfusion,2021,34(08):864-867.
[9]Duan Jinxia, Yan Bin, Sun Xiao, et al. The diagnostic value of blood routine and coagulation routine detection in severe novel coronavirus pneumonia[J].Laboratory Medicine and Clinical Medicine,2022,19(02):168-171.)
[10]Wang Xiaowu, Gao Yong, Wu Dong. The predictive value of coagulation indexes on the development of COVID-19[J].Laboratory Medicine,2021,36(01):57-59.
[11]Wang L, Liu T, Yue H, Zhang J, Sheng Q, Wu L, Wang X, Zhang M, Wang J, Wang J, Yu W. Clinical characteristics and high risk factors of patients with Omicron variant strain infection in Hebei, China. Front Cell Infect Microbiol. 2023 Dec 1;13:1294904.
[12]Esmaeel HM, Ahmed HA, Elbadry MI, Khalaf AR, Mohammed NA, Mahmoud HA, Taha EM. Coagulation parameters abnormalities and their relation to clinical outcomes in hospitalized and severe COVID-19 patients: prospective study. Sci Rep. 2022 Aug 1;12(1):13155.
[13]Yang T, Liu LL, Wu XH, Xue JG, He CY. Serum hyaluronic acid and procollagen III, N-terminal propeptide levels are highly associated with disease severity and predict the progression of COVID-19. Front Cell Infect Microbiol. 2023 Oct 4;13:1249038.
[14]Feng S, Wang F, Wu W, Li Y, Chen C, Li J, Cao M, Peng L, Zhang P, Wang F. Analysis of multiple organ function damage in patients with severe COVID-19 pneumonia. J Med Biochem. 2023 Aug 25;42(3):444-453.
[15]Chen X, Wang Q, Xu M, Li C. A Retrospective Analysis of the Coagulation Dysfunction in COVID-19 Patients. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620964868.
[16]Zou Y, Guo H, Zhang Y, Zhang Z, Liu Y, Wang J, Lu H, Qian Z. Analysis of coagulation parameters in patients with COVID-19 in Shanghai, China. Biosci Trends. 2020 Sep 21;14(4):285-289.
[17]Clinical value of combination of Chest CT pulmonary inflammation index,lactic acid and NLR in prognosis of COVID-19 pneumonia.
[18]Martín-Rojas RM, Chasco-Ganuza M, Casanova-Prieto S, Delgado-Pinos VE, Pérez-Rus G, Duque-González P, Sancho M, Díez-Martín JL, Pascual-Izquierdo C. A mild deficiency of ADAMTS13 is associated with severity in COVID-19: comparison of the coagulation profile in critically and noncritically ill patients. Blood Coagul Fibrinolysis. 2021 Oct 1;32(7):458-467.
[19]Rasyid A, Riyanto DL, Harris S, Kurniawan M, Mesiano T, Hidayat R, Wiyarta E. Association of coagulation factors profile with clinical outcome in patient with COVID-19 and acute stroke: A second wave cohort study. Clin Hemorheol Microcirc. 2022;82(4):371-377.
[20]Binsaleh NK, Eltayeb R, Sherwani S, Almishaal AA, Hindi EA, Qanash H, Bazaid AS, Alharbi AO, Bazaid MB, Altamimi SA. Comparison of Hematological Parameters Between Survivors and Non-Survivors COVID-19 Patients in Saudi Arabia. Int J Gen Med. 2023 Aug 31;16:3955-3962.
[21]Zhu H, Li Y, Su H, Yan C, Xin W, Ying K. What Is the Impact of Baseline Inflammatory and Hemostatic Indicators with the Risk of Mortality in Severe Inpatients with COVID-19: A Retrospective Study. Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241255959.
[22]Wei S, Xiaqin W, Liwei L, Fasu Z, Ying P, Pingping T, Furong Y. Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China. Cureus. 2024 May 10;16(5):e60069.
[23]Wu Jiao, Wang Peichun, Liu Xuan. Coagulation dysfunction in patients with novel coronavirus pneumonia and its possible mechanisms and treatment strategies[J].Journal of Shanghai University of Traditional Chinese Medicine,2022,36(06):90-100.
[24]Wu Di, Fan Xinxin, Shen Jianshan, et al. The diagnostic value of coagulation screening indexes and D-dimer in clinical classification of patients with novel coronavirus pneumonia[J].Journal of Tuberculosis and Lung Diseases,2021,2(04):355-360.
[25]Chen Huijuan, Chen Lijuan, Wei Shuo. Clinical characteristics and coagulation function analysis of patients infected with novel coronavirus Delta variant[J].Medical Theory & Practice,2022,35(22):3796-3798+3791.
[26]Guevara-Noriega KA, Lucar-Lopez GA, Nuñez G, Rivera-Aguasvivas L, Chauhan I. Coagulation Panel in Patients with SARS-CoV2 Infection (COVID-19). Ann Clin Lab Sci. 2020 May;50(3):295-298.
[27]Fu, Z. X., Huang, J., Wang, C. Z., Tang, X. A., & Deng, M. F. (2021). Preliminary study on the differential value of coagulation indexes and D-dimer level in the clinical classification of COVID-19 patient.
[28]Jin Y ,Cai L ,Cheng Z , et al.A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)[J].Military Medical Research,2020,7(01):1-22.
[29]on Prevention, National Cooperation Group. "Practice guidelines of thromboprophylaxis and management of anticoagulation in hospitalized patients with COVID-19." Zhonghua yi xue za zhi 103.12 (2023): 863-885.
[30]Zhan, Yang-Qing, et al. "Efficacy and safety of Lianhua Qingwen capsules combined with standard of care in the treatment of adult patients with mild to moderate COVID-19 (FLOSAN): protocol for a randomized, double-blind, international multicenter clinical trial." Journal of Thoracic Disease 15.5 (2023): 2859.
[31]Zhou Li, Qin Chuan.2019 Novel Coronavirus Pneumonia Coagulation Abnormal Mechanism and Traditional Chinese Medicine Blood Stasis Syndrome[J].China Journal of Comparative Medicine,2022,32(01):89-96.
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