THE ROLE OF HEMATOLOGICAL AND COAGULATION PARAMETERS IN SEVERITY OF COVID-19 IN ULIN REFERRAL HOSPITAL OF SOUTH KALIMANTAN

Abstract

COVID-19 was known to be a pandemic worldwide. South Kalimantan recorded a high Case Fatality Rate (CFR) of 2.92% until May 30, 2021. Deaths have been related to severe COVID-19 infection. Meanwhile, hematological and coagulation abnormalities are a concern in severe cases. Race, ethnicity, and demographic differences can influence result patterns. This retrospective study aimed to evaluate the role of these parameters in the determination of COVID-19 severity. Data were extracted from 455 confirmed COVID-19 patients in Ulin Referral Hospital between March – November 2020, include demographics, routine hematological tests, and hemostatic factors.  Variables were compared between a severe and non-severe group. Significant results were tested by univariate and multivariate analysis. We performed ROC curves to determine the cut-off and efficacy of predictive value in laboratories. We found that  older age (OR: 1.051, 95% CI: 1.032-1.071, P<0.001), high haemoglobin (Hb) level (OR:  1.239, 95% CI: 1.125-1.365, P<0.001), neutrophilia (OR: 1.066, 95% CI: 1.044-1.088,  P<0.001), Activated Partial Thromboplastin Time (APTT) prolongation [OR: 1.076, 95%  CI: 1.031-1.122, P=0.001] and elevated D-dimer (OR: 1.250, 95% CI: 1.110-1.407,  P<0.001) were significant predictors in severe cases. The cut-off values for Hb, Neutrophil, APTT, and D-dimer were 13.95 mg/dl, 70.5%, 27.5 seconds, and 1.005 mg/L, respectively. Neutrophils had the best efficacy with an AUC of 0.715. The study concluded that changes in hematological and coagulation have a role as predictive factors of the severity of COVID-19. Our findings were crucial for early diagnosis and intervention, also important to build data of COVID-19, especially in southeast Asia.