This study was created to analyze dynamic alterations in coagulation, hematological and biochemical parameters and their association with mortality of COVID-19 patients.
The present study was a prospective, one-year-long observational study conducted during the period September 2020/September 2021 on all critically ill, COVID–19 patients with respiratory failure, admitted to the Medical Intensive Care Unit (MICU) of the University Clinical Centre of the Republic of Srpska. The following data were collected: demographic and clinical characteristics of the study population, pre-existing comorbidities (cardiovascular diseases, pulmonary diseases, diabetes mellitus), coagulation, biochemical and hematological parameters. The primary outcome was the proportion of patients who died (non-survivors).
As much as 91 patients with median age 60 (50–67), 76.9% male, met the acute respiratory distress syndrome (ARDS) criteria. It was tested whether dynamic change (delta-Δ) of parameters (C-reactive protein-CRP, interleukin 6-IL-6, absolute lymphocyte count-Ly, fibrinogen, coagulation cascade factors: F II, factor II; F V, factor V, F X, factor X; F XI, factor XI; F XIII, factor XIII) that were found to be predictors of mortality is independently associated with poor outcome in patients. Adjusted (multivariate) analysis was used, where tested parameters were corrected for basic and clinical patients’ characteristics. The only inflammatory (biochemical and hematological) parameter which dynamic change had statistically significant odds ratio (OR) was ΔCRP (p < 0.005), while among coagulation parameters statistically significant OR was found for Δ fibrinogen (p < 0.005) in predicting mortality.
Coagulation, hematological and biochemical parameters' abnormalities are common in critically ill COVID–19 patients. Monitoring of these parameters and their dynamical changes can potentially improve management and predict mortality in critically ill COVID – 19 patients.