VPB0104 - Assessment of COVID -19 associated coagulopathy and multiple hemostatic markers in patients of upper Egypt.

Background: Coagulopathy is still a serious pattern of Coronavirus-19 disease. Its form and severity could determine the path of the patient and his outcome.

Aims: -Evaluate COVID-19 associated coagulopathy, thrombosis and disseminated intravascular coagulopathy among Egyptian patients.
-Assess coagulation acute phase reactants; Von Willebrand factor (VWF), (FVIII) , and acquired thrombophilia in the same patients and correlate them to severity and outcome of the patients.

Methods: Observational cross-sectional study included 106 COVID-19 patients, 51 controls, in accordance with Declaration of Helsinki and approved by ethics committees of Assiut University IBR 17300413. Informed consent was taken. Patients were divided according to severity and presence of thrombosis. Continuous variables compared with Student t test. Categorical data compared by Chi2 test. Correlation assessed by Pearson correlation. Diagnostic performance of VWF, lupus anticoagulant (LA) and antithrombin III (ATIII) were determined by ROC curve. Level of confidence was kept at 95%;P value was significant if < 0.05

Results: Results showed significantly higher aPTT, VWF, D-dimer, and LA1(screening) and LA2(confirmation) in patients than control group. Significantly higher INR, aPPT, D-dimer FVIII, VWF, LA1,2 and lower ATIII were detected in severe group (table1). ATIII had high diagnostic accuracy in severity prediction. We found significantly higher INR and VWF among patients with thrombotic events. For prediction of thrombosis; VWF at cutoff > 257.7 has 83.3% sensitivity and 83.3% specificity (figure1).

Conclusion(s): Our results are confirming the relationship between COVID-19 associated coagulopathy and severity, poor outcome of the patients; INR, aPPT and D-dimer are the bad prognostic markers. D-dimer is a chief tool in diagnosis, severity evaluation but not thrombosis prediction. FVIII, VWF and ATIII are markers of severity. VWF could be used as assistant/alternative of D-dimer in diagnosis, severity assessment and superior in thrombosis risk prediction. Sequent LA1,LA2 and their ratios to specify presence of LA didn't show difference between controls and patients.