Keywords
thromboelastography
clinical and laboratory characteristics
How to Cite
Abstract
In press
The article presents the associations of clinical, laboratory, and clinical and instrumental features of patients with COVID-19 with increased risks of death and survival. The final model for predicting the risks of developing a lethal outcome in COVID-19 was determined, which has high classification qualities (optimal threshold value of the calculated model is equal to -1.6149; sensitivity – 97.1%; and specificity – 82.6%. The purpose of our study was to determine the risks of developing fatal outcomes in patients with COVID-19 based on their clinical, laboratory and instrumental features. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University in accordance with the current bioethical norms and rules. All patients signed informed consent. 179 patients with COVID-19 aged 20–88 years (average age was [58.75±13.82] years) were observed. Medical and statistical calculations were performed using the IBM SPSS 25.0 software package. The associations of indicators with the binomial dependent variable were calculated using multiple logistic regression analysis with the calculation of β coefficients. The significance of differences was determined using the Mann-Whitney U-test with a threshold of statistical significance p=0.05. Based on the results, the final prognostic model of the risk of developing a lethal outcome of COVID-19 indicates an increased risk of death in COVID-19 with increasing age (by 13.9%), leukocyte count (by 14.4%), D-dimers (by 0.001%) on day 5–7. According to the model, an increase in the probability of survival in COVID-19 was significantly proved with an increase in hemoglobin (by 6.1%) at the day of hospitalization, monocyte count (by 17.1%) on day 5–7 and the use of ceftriaxone (by 87.8%).
Keywords: prognostication, thromboelastography, clinical and laboratory characteristics.
Archived: https://doi.org/10.5281/zenodo.12569086
References
Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-40. DOI: 10.1182/blood.2020006000. PMID: 32339221.
Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-40. DOI: 10.1016/S2352-3026(20)30145-9. PMID: 32407672.
Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in COVID-19. N Engl J Med. 2020;383(2):120-8. DOI: 10.1056/NEJMoa2015432. PMID: 32437596.
Miesbach W, Makris M. COVID-19: Coagulopathy, Risk of Thrombosis, and the Rationale for Anticoagulation. Clin Appl Thromb Hemost. 2020;26:1076029620938149. DOI: 10.1177/1076029620938149. PMID: 32677459.
Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with COVID-19 infection. A scoping review. Thromb Res. 2020;192:152-60. DOI: 10.1016/j.thromres.2020.05.039. PMID: 32485418
McFadyen JD, Stevens H, Peter K. The Emerging Threat of (Micro)Thrombosis in COVID-19 and its Therapeutic Implications. Circ Res. 2020;127(4):571-87. DOI: 10.1161/CIRCRESAHA.120.317447. PMID: 32586214.
Ahmed S, Zimba O, Gasparyan AY. Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad. Clin Rheumatol. 2020;39(9):2529-43. DOI: 10.1007/s10067-020-05275-1. PMID: 32654082.
Chekkal M, Deba T, Hadjali S, Lamara H, Oulaa H, Zouai K, Hariti G. Prevention and treatment of COVID-19-associated hypercoagulability: Recommendations of the Algerian society of transfusion and hemobiology. Transfus Clin Biol. 2020;27(4):203-6. DOI: 10.1016/j.tracli.2020.09.004. PMID: 33022374.
Violi F, Pastori D, Cangemi R, Pignatelli P, Loffredo L. Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge. Thromb Haemost. 2020;120(6):949-56. DOI: 10.1055/s-0040-1710317. PMID: 32349133.
Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020;99:47-56. DOI: 10.1016/j.ijid.2020.07.029. PMID: 32721533.
Coomes EA, Haghbayan H. Interleukin-6 in Covid-19: A systematic review and meta-analysis. Rev Med Virol. 2020;30(6):1-9. DOI: 10.1002/rmv.2141. PMID: 32845568.
Pranata R, Lim MA, Huang I, Raharjo SB, Lukito AA. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression. J Renin Angiotensin Aldosterone Syst. 2020;21(2):1470320320926899. DOI: 10.1177/1470320320926899. PMID: 32408793.
Pranata R, Huang I, Lim MA, Wahjoepramono EJ, July J. Impact of cerebrovascular and cardiovascular diseases on mortality and severity of COVID-19-systematic review, meta-analysis, and meta-regression. J Stroke Cerebrovasc Dis. 2020;29(8):104949. DOI: 10.1016/j.jstrokecerebrovasdis.2020.104949. PMID: 32410807.
Price LC, McCabe C, Garfield B, Worth SJ. Thrombosis and COVID-19 pneumonia: the clot thickens! Eur Respir J. 2020;56(1):2001608. DOI: 10.1183/13993003.01608-2020. PMID: 32554532.
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47. DOI: 10.1002/ajh.25829. PMID: 32282949.
McBane RD 2nd, Torres Roldan VD, Niven AS, Pruthi RK, Franco PM, Linderbaum JA. Anticoagulation in COVID-19: A Systematic Review, Meta-analysis, and Rapid Guidance From Mayo Clinic. Mayo Clin Proc. 2020;95(11):2467-86. DOI: 10.1016/j.mayocp.2020.08.030. PMID: 33153635.
Franchini M, Marano G, Cruciani M, Mengoli C, Pati I, Masiello F, et al. COVID-19-associated coagulopathy. Diagnosis (Berl). 2020;7(4):357-63. DOI: 10.1515/dx-2020-0078. PMID: 32683333.
Brown W, Lunati M, Maceroli M, Ernst A, Staley C, Johnson R, Schenker M. Ability of Thromboelastography to Detect Hypercoagulability: A Systematic Review and Meta-Analysis. J Orthop Trauma. 2020;34(6):278-86. DOI: 10.1097/BOT.0000000000001714. PMID: 31815829.
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