Coagulopathy of Patients with COVID-19 is Associated with Infectious and Inflammatory Markers

Figures & data

Table 1 Demographic and Clinical Characteristics of Patients with COVID-19

Variables	Total (n = 108)	Survivors (n = 28)	Non-Survivors (n = 80)	P value
Age, years	66.0 (57.0–73.8)	59.0 (32.3–69.5)	67.5 (59.3–75.0)	0.0024
Sex				0.0054
Female	35 (32%)	15 (54%)	20 (25%)
Male	73 (68%)	13 (46%)	60 (75%)
Current smoker	10 (9%)	1 (4%)	9 (11%)	0.45
Comorbidity
Hypertension	47 (44%)	5 (18%)	42 (53%)	0.0015
Diabetes	20 (19%)	4 (14%)	16 (20%)	0.58
COPD	5 (5%)	1 (4%)	4 (5%)	1
CHD	16 (15%)	4 (14%)	12 (15%)	1
CKD	6 (6%)	3 (11%)	3 (4%)	0.18
CLD	0	0	0
Malignancy	4 (4%)	0	4 (5%)	0.57
Surgery history	24 (22%)	2 (7%)	22 (28%)	0.033
Hospital stay, days	10.0 (6.0–15.0)	12.5 (8.0–15.8)	9.0 (6.0–13.8)	0.13
Time from symptom onset to admission, days	9.0 (6.0–12.0).	4.0 (3.0–9.0)	10.0 (7.3–13.0)	0.0004
Time from admission to ICU, days	4.0 (2.0–6.0)	3.0 (2.0–4.0)	4.0 (2.0–6.0)	0.26
Symptom
Fever	91 (84%)	24 (86%)	67 (84%)	1
Cough	83 (77%)	21 (75%)	62 (78%)	0.78
Sputum	49 (45%)	9 (32%)	40 (50%)	0.102
Fatigue or myalgia	54 (50%)	12 (43%)	42 (53%)	0.38
Nausea or vomiting	10 (9%)	3 (11%)	7 (9%)	0.71
Diarrhoea	17 (16%)	3 (11%)	14 (18%)	0.55
DVT	22 (20%)	0	22 (28%)	0.0008
GIB	6 (6%)	1 (4%)	5 (6%)	1
Cerebrovascular accident	3 (3%)	0	3 (4%)	0.57
SIC score (ISTH ≥ 4)	34 (31%)	1 (4%)	33 (41%)	< 0.0001
DIC score (ISTH ≥ 5)	42 (39%)	0	42 (53%)	< 0.0001
SOFA score	3.0 (2.0–4.0)	1.0 (1.0–2.0)	3.0 (2.0–4.0)	< 0.0001
Anti-coagulation therapy	42 (39%)	1 (4%)	41 (51%)	< 0.0001

Abbreviations: COVID-19, Coronavirus disease 2019; COPD, chronic obstructive pulmonary disease; CHD, coronary heart disease; CKD, chronic kidney disease; CLD, chronic liver disease; ICU, intensive care unit; DVT, deep vein thrombus; GIB, gastrointestinal bleeding; SIC, sepsis-induced coagulopathy; DIC, disseminated intravascular coagulation; SOFA, sequential or sepsis-related organ failure assessment.

Figure 1 Dynamic analysis of coagulation parameters in survivors, non-survivors, and all patients with COVID-19 in ICU. Absolute values of PT (A), APTT (B), d-dimer (C), PTA (D), INR (E), FDP (F), TT (G), Fbg (H), AT (I) of survivors (green), non-survivors (red) and all patients (blue) were analysed at different times after admission. Error bars, mean ± SEM, *p < 0.05, **p < 0.01, ***p < 0.001.

Figure 2 Dynamic analysis of infectious and inflammatory indicators in survivors, non-survivors, and all patients with COVID-19 in ICU. Concentrations of CRP (A), ESR (B), PCT (C), serum ferritin (D), IL-1β, (E), IL-6 (F), IL-8 (G), IL-10 (H), IL-2R (I), TNF-α (J) in serum of survivors (green), non-survivors (red), and all patients (blue) were analysed at different times after admission. Error bars, mean ± SEM, *p < 0.05, **p < 0.01, ***p < 0.001.

Table 2 Correlations Between Coagulopathy of COVID-19 Patients and Infectious and Inflammatory Markers

	CRP	ESR	PCT	Serum Ferritin	IL-1β	IL-6	IL-8	IL-10	IL-2R	TNF-α
	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
D-dimer	0.36	0.18	0.45	0.29	−0.07	0.16	0.22	0.07	0.45	0.06
	(0.0007)	(0.13)	(< 0.0001)	(0.02)	(0.72)	(0.29)	(0.21)	(0.71)	(0.007)	(0.72)
SIC score	0.28	−0.10	0.35	0.23	0.33	0.37	0.31	0.10	0.28	−0.11
	(0.006)	(0.39)	(0.0007)	(0.052)	(0.048)	(0.009)	(0.07)	(0.60)	(0.10)	(0.52)
DIC score	0.45	0.25	0.46	0.43	−0.06	0.20	0.27	0.33	0.48	−0.01
	(<0.0001)	(0.02)	(<0.0001)	(<0.0001)	(0.69)	(0.09)	(0.06)	(0.02)	(0.0005)	(0.94)

Abbreviations: COVID-19, Coronavirus disease 2019; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; PCT, procalcitonin; IL-1β, interleukin-1β; IL-6, interleukin-6; IL-8, interleukin-8; IL-10, interleukin-10; IL-2R, interleukin-2 receptor; TNF-α, tumor necrosis factor-α; SIC, sepsis-induced coagulopathy; DIC, disseminated intravascular coagulation.