Evaluation of coagulation parameters according to serum CRP levels in early stage COVID-19 patients

INTRODUCTION: An increase in the levels of inflammatory biomarkers is observed in coronavirus disease (COVID-19). Coagulopathy occurring during the course of the disease has also been associated with inflammation. In our study, we aimed to evaluate the coagulation parameters according to the severity of inflammation in patients with early stage COVID-19 disease.
METHODS: The study was carried out retrospectively in a third-level hospital between April 8 and August 20, 2020. The patients were divided into two groups according to polymerase chain reaction (PCR) results. Non-COVID-19 group consisted of 72 patients with negative, and COVID-19 group consisted of 247 patients with positive PCR results. According to the serum C-reactive protein (CRP) levels the COVID-19 patients were divided into three groups as follows: Group1 (CRP<10 mg/L; n=105), Group 2 ( CRP 10-50 mg/L; n=72), and Group 3 (CRP >50 mg/L; n=70). Age, CRP, and coagulation parameters including fibrinogen, D-dimer, aPTT, and PT were compared between the groups.
RESULTS: There were significant differences between the non-COVID-19 and COVID-19 patients in terms of age, CRP and coagulation parameters. Likewise, there was a significant difference among 3 groups regarding coagulation parameters. In the multinomial logistic regression analysis, only level of D-dimer was an independent risk factor among all groups, while PT was an independent risk factor between Groups 1, and 3.
DISCUSSION AND CONCLUSION: Our findings suggest that coagulopathy occurs in the early stage in relation to the severity of inflammation. For the diagnosis of COVID-19 disease and the detection of thrombotic complications; it is important to monitor results of the coagulation tests along with markers of inflammation from the early stages of the disease.