META-ANALYSIS AND SYSTEMATIC REVIEW OF COAGULATION DISBALANCES IN COVID-19: 41 STUDIES AND 17,601 PATIENTS

dc.contributor.authorLen, Polina
dc.contributor.authorIskakova, Gaukhar
dc.contributor.authorSautbayeva, Zarina
dc.contributor.authorKussanova, Aigul
dc.contributor.authorTauekelova, Ainur
dc.contributor.authorSugralimova, Madina
dc.contributor.authorAbdieva, Meruert
dc.contributor.authorPonomarev, Eugene
dc.contributor.authorTikhonov, Alexander
dc.contributor.authorBekbossynova, Makhabbat
dc.contributor.authorBarteneva, Natasha
dc.date.accessioned2022-08-10T10:34:22Z
dc.date.available2022-08-10T10:34:22Z
dc.date.issued2022-03-11
dc.description.abstractIntroduction: Coagulation parameters are important determinants for COVID-19 infection. We conducted meta-analysis to assess the association between early hemostatic parameters and infection severity. Methods: Electronic search was made for papers that addressed clinical characteristics of COVID-19 patients and disease severity. Results were filtered using exclusion and inclusion criteria and then pooled into a meta-analysis to estimate the standardized mean difference (SMD) with 95% confidence interval (CI) for D-dimers, fibrinogen, prothrombin time, platelet count (PLT), activated partial thromboplastin time. To explore the heterogeneity and robustness of our fundings, sensitivity and subgroup analyses were conducted. Publication bias was assessed with contour-enhanced funnel plots and Egger's test by linear regression. Coagulation parameters data from retrospective cohort study of 451 patients with COVID-19 at National Research Center for Cardiac Surgery were included in meta-analysis of published studies. Results: Overall, 41 original studies (17,601 patients) on SARS-CoV-2 were included. For the two groups of patients, stratified by severity, we identified that D-dimers, fibrinogen, activated partial thromboplastin time, and prothrombin time were significantly higher in the severe group [SMD 0.6985 with 95%CI (0.5155; 0.8815); SMD 0.661 with 95%CI (0.3387; 0.9833); SMD 0.2683 with 95%CI (0.1357; 0.4009); SMD 0.284 with 95%CI (0.1472; 0.4208)]. In contrast, PLT was significantly lower in patients with more severe cases of COVID-19 [SMD −0.1684 with 95%CI (−0.2826; −0.0542)]. Neither the analysis by the leave-one-out method nor the influence diagnostic have identified studies that solely cause significant change in the effect size estimates. Subgroup analysis showed no significant difference between articles originated from different countries but revealed that severity assessment criteria might have influence over estimated effect sizes for platelets and D-dimers. Contour-enhanced funnel plots and the Egger's test for D-dimers and fibrinogen revealed significant asymmetry that might be a sign of publication bias. Conclusions: The hemostatic laboratory parameters, with exception of platelets, are significantly elevated in patients with severe COVID-19. The two variables with strongest association to disease severity were D-dimers and fibrinogen levels. Future research should aim outside conventional coagulation tests and include analysis of clotting formation and platelet/platelet progenitors characteristics.en_US
dc.identifier.citationLen, P., Iskakova, G., Sautbayeva, Z., Kussanova, A., Tauekelova, A. T., Sugralimova, M. M., Dautbaeva, A. S., Abdieva, M. M., Ponomarev, E. D., Tikhonov, A., Bekbossynova, M. S., & Barteneva, N. S. (2022). Meta-Analysis and Systematic Review of Coagulation Disbalances in COVID-19: 41 Studies and 17,601 Patients. In Frontiers in Cardiovascular Medicine (Vol. 9). Frontiers Media SA. https://doi.org/10.3389/fcvm.2022.794092en_US
dc.identifier.issn2297-055X
dc.identifier.urihttps://doi.org/10.3389/fcvm.2022.794092
dc.identifier.urihttps://www.frontiersin.org/articles/10.3389/fcvm.2022.794092/full
dc.identifier.urihttp://nur.nu.edu.kz/handle/123456789/6566
dc.language.isoenen_US
dc.publisherFrontiers Mediaen_US
dc.relation.ispartofseriesFrontiers in Cardiovascular Medicine;Vol. 9
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/us/*
dc.subjectCOVID-19en_US
dc.subjectcoagulopathyen_US
dc.subjectthrombosisen_US
dc.subjectD-dimersen_US
dc.subjectplateletsen_US
dc.subjectfibrinogenen_US
dc.subjectprothrombin timeen_US
dc.subjectmegakaryocyteen_US
dc.subjectType of access: Open Accessen_US
dc.titleMETA-ANALYSIS AND SYSTEMATIC REVIEW OF COAGULATION DISBALANCES IN COVID-19: 41 STUDIES AND 17,601 PATIENTSen_US
dc.typeArticleen_US
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