VOLUME 18 NUMBER 1 (January to June 2025)

PSL%202021 vol14-no01-p12-28-Mikita%20and%20Padlan

SciEnggJ. 2025 18 (1) 028-037
available online: March 28, 2025
DOI: https://doi.org/10.54645/2025181TXV-14

*Corresponding author
Email Address: gtzamora@up.edu.ph
Date received: October 23, 2024
Date revised: October 23, 2024
Date accepted: January 26, 2025

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ARTICLE

Association of abnormal coagulation parameters with adverse clinical outcomes among patients with moderate to severe SARS-CoV-2 infection

Geraldine T. Zamora-Abrahan*1, Evelyn O. Salido1, Jaime Alfonso M. Aherrera2, Deonne Thaddeus V. Gauiran3, Ourlad Alzeus G. Tantengco4,5, Ana Flor G. Malundo6, Jonnel B. Poblete6, Fresthel Monica M. Climacosa7, Alric V. Mondragon8, Juan Raphael M. Gonzales1, Josephine Anne C. Lucero3, Ralph Elvi M. Villalobos9, John D. Anonuevo2, Aileen D. Wang9, and Felix Eduardo R. Punzalan9

1Division of Rheumatology, Department of Medicine, University of
      the Philippines College of Medicine, Manila, Philippines
2Division of Cardiology, Department of Medicine, University of
      the Philippines College of Medicine, Manila, Philippines
3Division of Hematology, Department of Medicine, University of
      the Philippines College of Medicine, Manila, Philippines
4Department of Physiology, College of Medicine, University of the
      Philippines Manila, Manila, Philippines
5Department of Biology, College of Science, De La Salle University,
      Manila, Philippines
6Division of Infectious Diseases, Department of Medicine,
      University of the Philippines College of Medicine, Manila,
      Philippines
7Department of Medical Microbiology, College of Public Health,
      University of the Philippines Manila
8Division of Allergy and Immunology, Department of Medicine,
      University of the Philippines College of Medicine, Manila,
      Philippines
9Division of Pulmonology, Department of Medicine, University of
      the Philippines College of Medicine, Manila, Philippines

KEYWORDS: thrombophilia, antiphospholipid, COVID-19, thrombosis, Philippines

Introduction: This study aimed to determine the association between thrombophilia and adverse clinical outcomes among hospitalized patients with moderate to severe COVID-19 in a tertiary COVID-19 referral hospital.

Materials and Methods: This is a cross-sectional study among adult patients hospitalized with moderate to severe COVID-19. Demographic, clinical characteristics, laboratory parameters, and clinical outcomes (in-hospital mortality, disease progression, thrombosis, and composite outcomes) were obtained. Multiple logistics regression was used to determine the association between abnormal coagulation parameters and the development of adverse outcomes.

Results: The most frequent coagulation abnormalities were elevated D-dimer (79.3%), abnormal platelet count (35.5%), and low fibrinogen (100%). A total of 81 (36.2%) participants developed the primary composite outcome (in-hospital mortality, disease progression, thrombosis, disseminated intravascular coagulation, or shock). 11 patients developed venous thrombosis, and eight patients had arterial thrombosis. The most common coagulation abnormality among those with thrombosis was an elevated D-dimer (89.5%) at >500 ug/L. Elevated D-dimer was associated with a 12.05-times increased risk of any composite outcome (p = 0.002). Leukocytosis was associated with 3.47-times increased odds of any composite outcome (p<0.001), 3.55-times increased odds of thrombosis (p=0.029), and 8.21-times increased odds of in-hospital mortality (p<0.001). Abnormal platelet count was associated with 2.61-times increased odds of in-hospital mortality (p=0.033).

Conclusions: There was a significant association between abnormal platelet count, elevated D-dimer level, leukocytosis, and positive ACL IgM with adverse clinical outcomes. This suggests the utility of these coagulation parameters in monitoring patients with severe COVID-19.

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