Coagulation dysfunction is associated with severity of COVID‐19: a meta‐analysis

Zhu, Jieyun; Pang, Jielong; Ji, Pan; Zhong, Zhimei; Li, Hongyuan; Li, Bocheng; Zhang, Jianfeng; Lu, Junyu

OBJECTIVE: To systematically analyse the blood coagulation features of coronavirus disease 2019 (COVID‐19) patients in order to provide a reference for clinical practice. METHODS: An electronic search in PubMed, EMbase, Web of Science, Scopus, CNKI, WanFang Data and VIP databases to identify studies describing the blood coagulation features of COVID‐19 patients from 1 January 2020 to 21 April 2020. Three reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta‐analysis was performed by using Stata12.0 software. RESULTS: Thirty‐four studies involving 6,492 COVID‐19 patients were included. Meta‐analysis showed that patients with severe disease showed significantly lower platelet count (WMD ‐16.29×10(9)/L, 95%CI ‐25.34 to ‐7.23) and shorter activated partial thromboplastin time (APTT; WMD ‐0.81s, 95%CI ‐1.94 to 0.33) but higher D‐dimer levels (WMD 0.44μg/ml, 95%CI 0.29 to 0.58), higher fibrinogen levels (WMD 0.51g/L, 95%CI 0.33 to 0.69) and longer prothrombin time (PT; WMD 0.65s, 95%CI 0.44 to 0.86). Patients who died showed significantly higher D‐dimer levels (WMD 6.58μg/ml, 95%CI 3.59 to 9.57), longer PT (WMD 1.27s, 95%CI 0.49 to 2.06) and lower platelet count (WMD ‐39.73×10(9)/L, 95%CI ‐61.99 to ‐17.45) than patients who survived. CONCLUSION: Coagulation dysfunction is common in severe COVID‐19 patients and it is associated with severity of COVID‐19. This article is protected by copyright. All rights reserved.