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

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 -16.29×109 /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 -39.73×109 /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.