Prolonged prothrombin time at admission predicts poor clinical outcome in COVID-19 patients

Table 1 Baseline characteristics of patients enrolled

Characteristics	Total, n = 213	Survival, n = 178	Death, n = 35	P value, death vs survival
Age in yr, median (IQR)	62 (51-69)	60 (49-67)	73 (65-84)	< 0.001
Sex
Male	95 (44.6%)	71 (39.9%)	24 (68.6%)	0.002
Comorbidities
Hypertension	59 (27.7%)	44 (24.7%)	15 (42.8%)	0.028
Diabetes	22 (10.3%)	18 (10.1%)	4 (11.4%)	0.815
Cardiovascular disease	17 (8.0%)	12 (6.7%)	5 (14.3%)	0.132
Cerebrovascular disease	10 (4.7%)	4 (2.2%)	6 (17.1%)	< 0.001
Chronic kidney disease	9 (4.2%)	5 (2.8%)	4 (11.4%)	0.02
COPD	10 (4.7%)	4 (2.2%)	6 (17.1%)	< 0.001
Malignancy	10 (4.7%)	8 (4.5%)	2 (5.7%)	0.755
Autoimmune disease	4 (1.9%)	3 (1.7%)	1 (2.9%)	0.641
Vital signs at admission
Heart rate as bpm, median (IQR)	85 (78-92)	84 (76-91)	86 (79-95)	0.198
SBP in mmHg, median (IQR)	125 (116-135)	125 (118-134)	124 (110-143)	0.535
DBP in mmHg, median (IQR)	76 (70-80)	77 (70-80)	74 (65-86)	0.683
Respiration rate times per min, median (IQR)	20 (18-21)	19 (18-20)	23 (19-27)	< 0.001
Spectrum
Moderate	83 (39.0%)	83 (46.6%)	0
Severe	79 (37.1%)	79 (44.4%)	0
Critical	51 (23.9%)	16 (9.0%)	35 (100.0%)
Symptom onset to admission/d, median (IQR)	10 (7-12)	10 (7-12)	10 (7-14)	0.453
Hospitalization stay in d, median (IQR)	27 (14-35)	32 (22-36)	6 (4-8)	< 0.001

BPM: Beats per min; COPD: Chronic obstructive pulmonary disease; DBP: Diastolic blood pressure; IQR: Interquartile range; SBP: Systolic blood pressure.

Table 2 Laboratory findings at admission

	Normal Range	Total, n = 213	Survival, n = 178	Death, n = 35	P value, death vs survival
Platelet count × 109/L, median (IQR)	125-350	204 (152-255)	211 (157-264)	169 (117-208)	0.002
Blood coagulation
PT/s, median (IQR)	9-13	12.1 (11.5-12.7)	12 (11.5-12.6)	12.9 (12.0-14.0)	< 0.001
APTT/s, median (IQR)	25-31.3	28.8 (26.5-31.3)	28.6 (26.2-31.2)	29.8 (28.2-32.9)	0.033
TT/s, median (IQR)	14-21	17.3 (16.5-18.3)	17.3 (16.4-18.2)	17.6 (16.7-19.5)	0.099
Fibrinogen in g/L, median (IQR)	2-4	4.10 (3.32-5.12)	4.17 (3.39-5.12)	3.94 (2.49-5.18)	0.294
D-dimer in mg/L, median (IQR)	0-0.55	0.73 (0.40-1.95)	0.62 (0.37-1.63)	2.72 (0.91-17.45)	< 0.001
FDP in mg/L, median (IQR)	0-5	2.72 (1.05-7.05)	2.10 (0.98-5.33)	9.68 (3.20-90.68)	< 0.001
Incidence of coagulation abnormalities
Thrombocytopenia		26 (12.2%)	17 (9.6%)	9 (25.7%)	0.02
Thrombocytosis		10 (4.7%)	10 (5.6%)	0	0.374
PT prolongation		39 (18.8%)	23 (14.6%)	16 (45.7%)	< 0.001
APTT prolongation		56 (26.3%)	41 (23.0%)	15 (42.6)	0.02
APTT shortening		27 (12.7%)	25 (14.0%)	2 (5.7%)	0.265
TT prolongation		8 (3.8%)	3 (1.7%)	5 (14.2%)	0.004
Fibrinogen elevation		105 (49.29%)	89 (50%)	16 (45.7%)	0.708
Fibrinogen reduction		9 (4.7%)	5 (2.8%)	4 (11.4%)	0.043
D-dimer elevation		123 (57.7%)	92 (51.7%)	31 (88.6%)	< 0.001
FDP elevation		66 (31.0%)	47 (26.4%)	19 (54.3%)	0.002

APTT: Activated partial thromboplastin time; COPD: Chronic obstructive pulmonary disease; FDP: Fibrin degradation products; IQR: Interquartile range; PT: Prothrombin time; TT: Thrombin time.

Table 3 Univariate and multivariate logistic regression for prognosis factors

Factors	OR	95%CI	P value
Univariate analysis
Age	1.083	1.048-1.120	< 0.001
Male	3.288	1.516-7.131	0.003
Hypertension	2.284	2.284-1.078	0.031
Cerebrovascular disease	9.000	2.393-33.854	0.001
Chronic kidney disease	4.465	1.135-17.556	0.032
COPD	9.000	2.393-33.854	0.001
Respiration rate	1.192	1.098-1.293	< 0.001
PT	2.734	1.778-4.202	< 0.001
D-dimer	1.062	1.021-1.105	0.003
FDP	1.031	1.017-1.044	< 0.001
Multivariate analysis
Age	1.074	1.034-1.115	< 0.001
RR	1.223	1.095-1.366	< 0.001
PT	2.190	1.285-3.733	0.004
FDP	1.020	1.004-1.037	0.014

CI: Confidence interval; COPD: Chronic obstructive pulmonary disease; FDP: Fibrin degradation products; OR: Odds ratio; PT: Prothrombin time.