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Meta-Analysis
. 2024 Dec 2;24(1):1373.
doi: 10.1186/s12879-024-10229-y.

The association between mortality due to COVID-19 and coagulative parameters: a systematic review and meta-analysis study

Alireza Abdollahi  1 , Saeed Nateghi  2 , Zahra Panahi  3 , Seyed Hassan Inanloo  4 , Samaneh Salarvand  5 , Seyed Morteza Pourfaraji  6
Affiliations
Meta-Analysis

The association between mortality due to COVID-19 and coagulative parameters: a systematic review and meta-analysis study

Alireza Abdollahi et al. BMC Infect Dis. .

Abstract

Aims and objectives: This systematic review and meta-analysis study evaluated the association between mortality due to COVID-19 and coagulative factors.

Methods: A systematic search was conducted on electronic databases including PubMed, Scopus, and the Web of Science from the beginning of the pandemic until October 2024 to identify relevant studies on COVID-19 patients and their laboratory findings related to coagulation markers and mortality outcome. Eligibility criteria were defined based on the PICO framework, and data extraction was performed by two authors independently using a standardized sheet. Statistical analysis was accomplished using the random effects model, and heterogeneity among studies was assessed using the I2 test. R and RStudio were used for statistical analysis and visualization.

Results: Our systematic literature search yielded 6969 studies, with 48 studies meeting the inclusion criteria for our meta-analysis. The mean platelet count was significantly lower in deceased COVID-19 patients compared to survivors (20.58), while activated partial thromboplastin time (aPTT) and fibrinogen levels did not show significant differences. The pooled mean difference of D-Dimer, International Normalized Ratio (INR), and prothrombin time (PT) were significantly lower in survived patients (-2.45, -0.10, and -0.84, respectively). These findings suggest that platelet count, D-Dimer, INR, and PT may serve as potential indicators of mortality in COVID-19 patients.

Conclusion: The results of our systematic review and meta-analysis revealed a significant reduction in the pooled platelet count among deceased individuals when compared to survivors. However, no significant distinctions were observed in the pooled mean activated aPTT and fibrinogen levels between the deceased and survivor groups. On the other hand, there were noticeable variations in the pooled estimated mean of INR, PT, and D-Dimer levels, with significantly higher values in the deceased group compared to those who survived.

Keywords: COVID-19; Coagulopathy; D-dimers; Fibrinogen; Meta-analysis; Mortality; Prothrombin time.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The protocol for this systematic review was approved by the ethics committee at IKHC ethics committee (Ethics code: IR.TUMS.IKHC.REC.1399.102). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the systematic search and study selection
Fig. 2
Fig. 2
The mean difference between Platelet count among the survivors and the deceased was 20.58 and was significantly higher among the survivors
Fig. 3
Fig. 3
The mean difference between aPTT count among the survivors and the deceased was -0.60 and was not significantly lower among the deceased
Fig. 4
Fig. 4
The mean difference between D-Dimer count among the survivors and the deceased was -2.45 and was significantly lower among the survived
Fig. 5
Fig. 5
The mean difference between Fibrinogen count among the survivors and the deceased was -0.25 and was not significantly lower among the deceased
Fig. 6
Fig. 6
The mean difference between INR count among the survivors and the deceased was -0.10 and was significantly lower among the survived
Fig. 7
Fig. 7
The mean difference between PT count among the survivors and the deceased was -0.84 and was significantly lower among the survived
See this image and copyright information in PMC

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References

    1. Wolny M, Dittrich M, Knabbe C, Birschmann I. Immature platelets in COVID-19. Platelets. 2023;34(1):2184183. - PubMed
    1. Russell L, Weihe S, Madsen EK, Hvas CL, Leistner JW, Michelsen J, et al. Thromboembolic and bleeding events in ICU patients with COVID-19: a nationwide, observational study. Acta Anaesthesiol Scand. 2023;67(1):76–85. - PMC - PubMed
    1. Rurua M, Ratiani L, Sanikidze T, Machvariani K, Pachkoria E, Ormocadze G, et al. Impact of the angiotensin-converting enzyme (ACE) inhibitors on the course of the septic shock developed during covid-19 and other severe respiratory infections in presence of hyperferritinemia. Georgian Med News. 2023;337:110–7. - PubMed
    1. Shoaee S, Rezaie F, Payab M, Bakhtiari F, Heydari M-H. Experiences from the management of COVID-19 pandemic in a nursing home in Iran (March–April, 2020). J Diabetes Metab Disord. 2022;21(1):1195–9. - PMC - PubMed
    1. Zhu G, Modepalli S, Anand M, Li H. Computational modeling of hypercoagulability in COVID-19. Comput Methods Biomech Biomed Engin. 2023;26(3):338–49. - PubMed

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