The most important biomarker associated with coagulation and inflammation among COVID-19 patients

Abstract

Coronavirus disease 2019 (COVID-19) induced by SARS-Cov-2 can be related to coagulopathy. Also, the infection-induced inflammatory changes are found in patients with disseminated intravascular coagulopathy (DIC). The lack of previous immunity to COVID-19 has caused infection of a large number of patients worldwide and unpredictability regarding the management of the complications that appear in the course of this viral illness. Lungs are the most important target organ of the SARS-COV-2. In COVID-19 patients, acute lung injury leads to respiratory failure. However, multiorgan failure can also occur in these patients. The primary coagulopathy of COVID-19 is marked by a considerable elevation of D-dimer, ferritin, and fibrinogen degradation products. In comparison, abnormalities in platelet count, prothrombin time, and partial thromboplastin time are partly uncommon in initial presentations. Inflammatory biomarkers including CRP, LDH, and IL-6 are significantly elevated in the early stages of the disease. In this regard, inflammation-associated biomarkers and coagulation test screening, including the assessment of IL-6, CRP, LDH, D-dimer, platelet count, PT&PTT time, ferritin, and fibrinogen levels are suggested for detecting infection by this virus. Overall, COVID-19-associated coagulopathy should be managed like other patients with critical conditions, and supportive care and thromboembolic prophylaxis should be used for severe patients.

Keywords: COVID-19; Coagulation; D-dimer.

Fig. 1

In COVID-19 patients, activation of coagulation-related factors and the immune system leads to blood clots in the vessels. Activation of coagulation in the pulmonary artery causes pulmonary embolism. These factors cause changes in coagulation-related biomarkers (D-dimer, CRP, PT and PTT, IL-6, fibrinogen, platelet count, LDH, neutrophil and lymphocyte). C-reactive protein (CRP), partial thromboplastin time (PTT), prothrombin time (PT), Interleukin-6 (IL-6), lactate dehydrogenase (LDH)