Plasma haemostatic levels in COVID-19 patients and healthy controls: A comparative study at Two tertiary Hospitals in Zambia

Alick Mwambungu 1, *, Lydia Korolova 2 and Bornwell Sikateyo 3

1 Department of Biomedical Sciences, Institute of Distance Education, University of Zambia, Zambia.
2 Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Zambia.
3 Department of Medical Education Development School of Medicine, University of Zambia, Zambia.
 
Research Article
International Journal of Science and Research Archive, 2023, 10(01), 419–434.
Article DOI: 10.30574/ijsra.2023.10.1.0770
Publication history: 
Received on 11 August 2023; revised on 20 September 2023; accepted on 23 September 2023
 
Abstract: 
COVID-19 is a novel coronavirus disease that has caused a global pandemic with millions of confirmed cases and deaths worldwide. One of the major complications associated with COVID-19 is the development of a hypercoagulable state, leading to thrombotic events such as venous thromboembolism, pulmonary embolism, stroke, and myocardial infarction. The pathophysiology of COVID-19-associated coagulopathy involves a complex interplay between viral infection, host immune response, endothelial dysfunction, and inflammatory cytokine storm.
The main objective of this study was to evaluate Plasma Haemostatic Levels in COVID-19 Patients and Healthy Controls and its association with COVID-19 severity levels.
This was a mixed-methods research project that employed cross-sectional and case-control study designs. The study population consisted of SARS-CoV-2 positive patients at Ndola Teaching Hospital (NTH) and Levy Mwanawasa University Teaching Hospital (LMUTH). The laboratory tests included the assessment of haemostatic profiles in COVID-19 patients compared to control subjects. Additionally, this study explored the use of haemostatic profiles in classifying COVID-19 severity in relation to the clinical methods currently in use. Data analysis was performed using SPSS version 21.
Our study observed elevated plasma levels of haemostatic profiles such as D-dimer, Von Willebrand Factor (VWF), VWF/ADAMTS13 ratio, Factor VIII, Plasminogen Activator Inhibitor (PAI), and Soluble P-selectin in COVID-19 patients compared to the control group. Additionally, COVID-19 patients exhibited a higher prevalence of hypercoagulability (57.2%) compared to control participants (3%). The study also found that the frequency of coagulability increased with COVID-19 severity. Furthermore, statistically significant differences in mean haemostatic plasma concentration were observed in relation to COVID-19 disease severity.
In conclusion, our study found that COVID-19 patients exhibited elevated haemostatic parameters compared to healthy controls. These parameters were observed to correlate with COVID-19 severity levels. The study provides valuable insights into the haemostatic mechanisms of COVID-19 and identifies potential biomarkers for hypercoagulability. These findings may have implications for the diagnosis, prognosis, and management of COVID-19 patients. Clinicians can utilize this information to identify patients with a poor prognosis and assess disease severity, enabling early intervention.
 
Keywords: 
COVID-19; Sars-Cov-2; D-dimer; Hypercoagulability; Biomarker; Endothelium
 
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