Analysis of Dynamic Disturbance in Blood Coagulation Function of Patients with Coronavirus Disease 2019: A Retrospective Observational Study.

Coronavirus Disease 2019 (COVID-19) has became a major problem affecting global health security. To assess the differences and dynamic changes of blood coagulation function in COVID-19 patients with different severity. A total of 261 COVID-19 patients from January 24 to March 25, 2020 in Huangshi, Hubei Province were enrolled. We designed a retrospective observational study. Clinical information, including age, blood routine and blood coagulation function, were collected. According to the Diagnosis and Treatment Guidelines for COVID-19 (seventh version) that issued by the National Health Committee of the People's Republic of China, patients were divided into 3 subgroups: 186 ordinary, 45 severe and 30 critical ones. We compared the differences in blood coagulation factors among groups. Average age in critical group (71.47 +/- 11.48 years) was the oldest of 3 subgroups. At admission, statistically differences could be observed among ordinary, severe and critical patients in D-dimer (0.18 +/- 0.33, 0.63 +/- 1.13 and 1.16 +/- 1.58 mg/L), fibrinogen/fibrin degradation products (FDP) (3.11 +/- 5.30, 9.82 +/- 23.91 and 21.94 +/- 40.98 mu g/ml), platelet [(169 +/- 62.85), (188 +/- 71.56) and (117 +/- 38.31) x 10(9)/L)] and lymphocyte count [(1.18 +/- 0.46), (0.82 +/- 0.35) and (0.75 +/- 0.39) x 10(9)/L)], respectively (P < .05). During hospitalization, the peak values of coagulation and valley values of blood routine were monitored. There were significant differences among ordinary, severe and critical patients in D-dimer (0.26 +/- 0.46, 1.39 +/- 1.51 and 2.89 +/- 1.68 mg/L), FDP (3.29 +/- 5.52, 23.68 +/- 39.07 and 56.11 +/- 49.94 mu g/ml), platelet [(164 +/- 55.53), (171 +/- 69.96) and (84 +/- 57.80) x 10(9)/L)] and lymphocyte count [(1.10 +/- 0.46), (0.65 +/- 0.35) and (0.55 +/- 0.31) x 10(9)/L)], respectively (P < .001). D-dimer and FDP in the course of disease in severe/critical groups showed a first upward and then downward trend. We concluded that coagulation function indexes such as D-dimer and FDP could be served as markers to estimate COVID-19 patients condition. Close monitoring of coagulation function may be helpful for early diagnosis of severe patients and guidance of treatments.