Correlation of coagulation parameters with clinical outcomes in Coronavirus-19 affected minorities in United States: Observational cohort
Abstract
Importance
COVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the United States. Currently Bronx has the highest prevalence per capita in New York.
Objective
To investigate the coagulopathic presentation of COVID and its natural course and to investigate whether hematologic and coagulation parameters can be used to assess illness severity and death.
Design
Retrospective case study of positive COVID inpatients between 3/20/2020-3/31/2020.
Setting
Montefiore Health System main hospital, Moses, a large tertiary care center in the Bronx.
Participants
Adult inpatients with positive COVID tests hospitalized at MHS.
Exposure (for observational studies)
Datasets of participants were queried for physiological, demographic (age, sex, socioeconomic status and self-reported race and/or ethnicity) and laboratory data.
Main Outcome and Measures
Relationship and predictive value of measured parameters to mortality and illness severity.
Results
Of the 217 in this case review, 70 died during hospitalization while 147 were discharged home. Only the admission PT and first D-Dimer could very significantly differentiate those who were discharged alive and those who died. Logistic regression analysis shows increased odds ratio for mortality by first D-Dimer within 48 hrs. of admission. The optimal cut-point for the initial D-Dimer to predict mortality was found to be 1.65 μg/mL
Conclusions
We describe here a comprehensive assessment of hematologic and coagulation parameters in COVID and examine the relationship of these to mortality. We demonstrate that both initial and maximum D-Dimer values are biomarkers that can be used for survival assessments.
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