Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients
IntroductionCoagulation parameters are important determinants for COVID-19 infection. We conducted meta-analysis to assess the association between early hemostatic parameters and infection severity.MethodsElectronic search was made for papers that addressed clinical characteristics of COVID-19 patie...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.794092/full |
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| author | Polina Len Gaukhar Iskakova Zarina Sautbayeva Aigul Kussanova Aigul Kussanova Ainur T. Tauekelova Madina M. Sugralimova Anar S. Dautbaeva Meruert M. Abdieva Eugene D. Ponomarev Alexander Tikhonov Makhabbat S. Bekbossynova Natasha S. Barteneva Natasha S. Barteneva |
| author_facet | Polina Len Gaukhar Iskakova Zarina Sautbayeva Aigul Kussanova Aigul Kussanova Ainur T. Tauekelova Madina M. Sugralimova Anar S. Dautbaeva Meruert M. Abdieva Eugene D. Ponomarev Alexander Tikhonov Makhabbat S. Bekbossynova Natasha S. Barteneva Natasha S. Barteneva |
| author_sort | Polina Len |
| collection | DOAJ |
| description | IntroductionCoagulation parameters are important determinants for COVID-19 infection. We conducted meta-analysis to assess the association between early hemostatic parameters and infection severity.MethodsElectronic search was made for papers that addressed clinical characteristics of COVID-19 patients and disease severity. Results were filtered using exclusion and inclusion criteria and then pooled into a meta-analysis to estimate the standardized mean difference (SMD) with 95% confidence interval (CI) for D-dimers, fibrinogen, prothrombin time, platelet count (PLT), activated partial thromboplastin time. To explore the heterogeneity and robustness of our fundings, sensitivity and subgroup analyses were conducted. Publication bias was assessed with contour-enhanced funnel plots and Egger's test by linear regression. Coagulation parameters data from retrospective cohort study of 451 patients with COVID-19 at National Research Center for Cardiac Surgery were included in meta-analysis of published studies.ResultsOverall, 41 original studies (17,601 patients) on SARS-CoV-2 were included. For the two groups of patients, stratified by severity, we identified that D-dimers, fibrinogen, activated partial thromboplastin time, and prothrombin time were significantly higher in the severe group [SMD 0.6985 with 95%CI (0.5155; 0.8815); SMD 0.661 with 95%CI (0.3387; 0.9833); SMD 0.2683 with 95%CI (0.1357; 0.4009); SMD 0.284 with 95%CI (0.1472; 0.4208)]. In contrast, PLT was significantly lower in patients with more severe cases of COVID-19 [SMD −0.1684 with 95%CI (−0.2826; −0.0542)]. Neither the analysis by the leave-one-out method nor the influence diagnostic have identified studies that solely cause significant change in the effect size estimates. Subgroup analysis showed no significant difference between articles originated from different countries but revealed that severity assessment criteria might have influence over estimated effect sizes for platelets and D-dimers. Contour-enhanced funnel plots and the Egger's test for D-dimers and fibrinogen revealed significant asymmetry that might be a sign of publication bias.ConclusionsThe hemostatic laboratory parameters, with exception of platelets, are significantly elevated in patients with severe COVID-19. The two variables with strongest association to disease severity were D-dimers and fibrinogen levels. Future research should aim outside conventional coagulation tests and include analysis of clotting formation and platelet/platelet progenitors characteristics. |
| first_indexed | 2024-12-22T07:23:04Z |
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| id | doaj.art-0f183b6ab2e148b2b5315ddbf2ae3f6e |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-22T07:23:04Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-0f183b6ab2e148b2b5315ddbf2ae3f6e2022-12-21T18:34:12ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.794092794092Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 PatientsPolina Len0Gaukhar Iskakova1Zarina Sautbayeva2Aigul Kussanova3Aigul Kussanova4Ainur T. Tauekelova5Madina M. Sugralimova6Anar S. Dautbaeva7Meruert M. Abdieva8Eugene D. Ponomarev9Alexander Tikhonov10Makhabbat S. Bekbossynova11Natasha S. Barteneva12Natasha S. Barteneva13School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanSchool of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanSchool of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanSchool of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanCore Facilities, Nazarbayev University, Nur-Sultan, KazakhstanNational Research Center for Cardiac Surgery, Nur-Sultan, KazakhstanNational Research Center for Cardiac Surgery, Nur-Sultan, KazakhstanNational Research Center for Cardiac Surgery, Nur-Sultan, KazakhstanNational Research Center for Cardiac Surgery, Nur-Sultan, KazakhstanSchool of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, ChinaSchool of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanNational Research Center for Cardiac Surgery, Nur-Sultan, KazakhstanSchool of Sciences and Humanities, Nazarbayev University, Nur-Sultan, KazakhstanHarvard Medical School, Brigham and Women's Hospital, Boston, MA, United StatesIntroductionCoagulation parameters are important determinants for COVID-19 infection. We conducted meta-analysis to assess the association between early hemostatic parameters and infection severity.MethodsElectronic search was made for papers that addressed clinical characteristics of COVID-19 patients and disease severity. Results were filtered using exclusion and inclusion criteria and then pooled into a meta-analysis to estimate the standardized mean difference (SMD) with 95% confidence interval (CI) for D-dimers, fibrinogen, prothrombin time, platelet count (PLT), activated partial thromboplastin time. To explore the heterogeneity and robustness of our fundings, sensitivity and subgroup analyses were conducted. Publication bias was assessed with contour-enhanced funnel plots and Egger's test by linear regression. Coagulation parameters data from retrospective cohort study of 451 patients with COVID-19 at National Research Center for Cardiac Surgery were included in meta-analysis of published studies.ResultsOverall, 41 original studies (17,601 patients) on SARS-CoV-2 were included. For the two groups of patients, stratified by severity, we identified that D-dimers, fibrinogen, activated partial thromboplastin time, and prothrombin time were significantly higher in the severe group [SMD 0.6985 with 95%CI (0.5155; 0.8815); SMD 0.661 with 95%CI (0.3387; 0.9833); SMD 0.2683 with 95%CI (0.1357; 0.4009); SMD 0.284 with 95%CI (0.1472; 0.4208)]. In contrast, PLT was significantly lower in patients with more severe cases of COVID-19 [SMD −0.1684 with 95%CI (−0.2826; −0.0542)]. Neither the analysis by the leave-one-out method nor the influence diagnostic have identified studies that solely cause significant change in the effect size estimates. Subgroup analysis showed no significant difference between articles originated from different countries but revealed that severity assessment criteria might have influence over estimated effect sizes for platelets and D-dimers. Contour-enhanced funnel plots and the Egger's test for D-dimers and fibrinogen revealed significant asymmetry that might be a sign of publication bias.ConclusionsThe hemostatic laboratory parameters, with exception of platelets, are significantly elevated in patients with severe COVID-19. The two variables with strongest association to disease severity were D-dimers and fibrinogen levels. Future research should aim outside conventional coagulation tests and include analysis of clotting formation and platelet/platelet progenitors characteristics.https://www.frontiersin.org/articles/10.3389/fcvm.2022.794092/fullCOVID-19coagulopathythrombosisD-dimersplateletsfibrinogen |
| spellingShingle | Polina Len Gaukhar Iskakova Zarina Sautbayeva Aigul Kussanova Aigul Kussanova Ainur T. Tauekelova Madina M. Sugralimova Anar S. Dautbaeva Meruert M. Abdieva Eugene D. Ponomarev Alexander Tikhonov Makhabbat S. Bekbossynova Natasha S. Barteneva Natasha S. Barteneva Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients Frontiers in Cardiovascular Medicine COVID-19 coagulopathy thrombosis D-dimers platelets fibrinogen |
| title | Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients |
| title_full | Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients |
| title_fullStr | Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients |
| title_full_unstemmed | Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients |
| title_short | Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients |
| title_sort | meta analysis and systematic review of coagulation disbalances in covid 19 41 studies and 17 601 patients |
| topic | COVID-19 coagulopathy thrombosis D-dimers platelets fibrinogen |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.794092/full |
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