COVID-19 Research Paper Volume 12, Issue 16 pp 15918—15937

Early coagulation tests predict risk stratification and prognosis of COVID-19

Lili Luo1,2, *, , Min Xu1,2, *, , Mengyi Du1,2, *, , Haiming Kou1,2, , Danying Liao1,2, , Zhipeng Cheng1,2, , Heng Mei1,2, , Yu Hu1,2, ,

  • 1 Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • 2 Hubei Clinical and Research Centre of Thrombosis and Hemostasis, Wuhan 430022, China
* Co-first authors

Received: April 28, 2020       Accepted: June 9, 2020       Published: August 29, 2020
How to Cite

Copyright © 2020 Luo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) is hitting the world hard, but the relationship between coagulation disorders and COVID-19 is still not clear. This study aimed to explore whether early coagulation tests can predict risk stratification and prognosis. PubMed, Web of Science, Cochrane Library, and Scopus were searched electronically for relevant research studies published up to March 24, 2020, producing 24 articles for the final inclusion. The pooled standard mean difference (SMD) of coagulation parameters at admission were calculated to determine severe and composite endpoint conditions (ICU or death) in COVID-19 patients. Meta-analyses revealed that platelet count was not statistically related to disease severity and composite endpoint; elevated D-dimer correlated positively with disease severity (SMD 0.787 (0.277-1.298), P= 0.003, I2= 96.7%) but had no significant statistical relationship with composite endpoints. Similarly, patients with prolonged prothrombin time (PT) had an increased risk of ICU and increased risk of death (SMD 1.338 (0.551-2.125), P = 0.001, I2 = 92.7%). Besides, increased fibrin degradation products (FDP) and decreased antithrombin might also mean the disease is worsening. Therefore, early coagulation tests followed by dynamic monitoring is useful for recognizing coagulation disorders accompanied by COVID-19 and guiding timely therapy to improve prognosis.


COVID-19: Coronavirus Disease 2019; SARS-Cov-2: severe acute respiratory syndrome coronavirus 2; ARDS: acute respiratory distress syndrome; MERS-CoV: Middle East Respiratory Syndrome coronavirus; DIC: disseminated intravascular coagulation; PT: prothrombin time; APTT: activated partial thromboplastin time; FDP: fibrin/fibrinogen degradation products; SMD: standard mean differences; VTE: venous thromboembolism. NOS:Newcastle-Ottawa quality assessment scale.