Prognostic Value of Fibrinogen among COVID-19 Patients Admitted to an Emergency Department: An Italian Cohort Study

Journal of Clinical Medicine

Michele Imparato¹  Vincenzo Russo²  Novella Carannante³  Corrado Lodigiani⁴  PierpaoloDi Micco⁵  Giuseppe Cardillo⁵ 

[1] [e-mail];Chair of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”—Monaldi hospital,piazzale Ettore Ruggeri, 80131 Naples, Italy;Emergenza Infettivologica—Pronto Soccorso Ospedale Cotugno, AO dei Colli, 80131 Naples, Italy;Medylab, Biochimica avanzata Laboratory, 80131 Napoli, Italy;UOC Medicina, Fatebenefratelli Hospital of Naples, 80131 Naples, Italy;

关键词: COVID-19;    SARS-CoV-2;    hemostasis;    disseminated intravascular coagulation;    fibrinogen;    D-dimer;   

DOI  :  10.3390/jcm9124134

来源: DOAJ

【 摘 要 】

Introduction: A highly pathogenic human coronavirus able to induce severe acute respiratory syndrome (SARS) has been recently recognized as the cause of the coronavirus disease 2019 (COVID-19); the disease became pandemic after a few months. Little is still known about the laboratory prognostic markers in COVID-19 patients. The aim of our study was to describe the prognostic value of clotting parameters for the prediction of severe form of COVID-19 characterized by acute respiratory distress syndrome (ARDS) at hospital admission.Material and Methods: From a large cohort of 152 patients consecutively admitted from February to March 2020 for fever and dyspnea to the emergency departments (ED) of three Italian hospitals, we evaluated 85 patients with confirmed diagnosis of COVID-19 and 67 patients with acute illness. All patients underwent medical history checks, physical examination, and laboratory evaluation. Prothrombin time (PT), activated thromboplastin time (aPTT), fibrinogen and D-dimer tests were performed and compared,first, between COVID-19 and control groups, and then between COVID-19 patients with or without ARDS.Results: COVID-19 patients were more likely to show abnormal baseline levels of PT, aPTT, D-dimer, and fibrinogen at admission compared to the control group. COVID-19 patients with ARDS showed a statistically significant increase in levels of fibrinogen compared to those without ARDS (720 (621–833) vs. 490 (397.5–601.5); p= 1.8653·10-9 (0.0765). A cut-off value of 617 mg/dL had a sensitivity of 76% and a specificity of 79% in identifying COVID-19 patients with ARDS.Conclusion: A serum level of fibrinogen of 617 mg/dL in COVID-19 patients admitted to emergency department may help to identify early those with ARDS.

【 授权许可】

Unknown