Different SARS-CoV-2 Subvariants and Coagulation Markers Trend: A Retrospective Multicentric Study From Iranian Network for Research in Viral Diseases (INRVD).

BACKGROUND AND AIMS: This study aims to examine the prevalence and progression of coagulation disorders in adult COVID-19 patients and evaluate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on coagulation markers.

METHODS

This retrospective study included 1885 hospitalized COVID-19 patients, aged 20 to over 90 years, from January 23, 2020, to March 9, 2021, across 23 centers in 13 provinces in Iran. Patients were categorized into three epidemiological peaks corresponding to different pandemic waves and SARS-CoV-2 variants (wild-type, B.1.36, and B.1.1.413). Data collection and statistical analysis adhered to the Iranian Center for Disease Control guidelines, with laboratory assessments focusing on hematologic and coagulation markers, including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet (PLT) count, and Hemoglobin (Hb). Parameters were assessed to monitor coagulation dynamics and thrombotic risk over time and across epidemic waves. Estimated marginal means enabled evaluation of biomarker fluctuations by time and sex.

RESULTS

The majority of patients were below 70 years of age, with hypertension and diabetes as common underlying conditions. The study revealed a trend of increasing white blood cells, neutrophils, neutrophil-to-lymphocyte ratio, and PLTs during the initial week. Conversely, hemoglobin and lymphocytes exhibited a downward trend. PLT, lymphocyte, and neutrophil levels were not significantly affected by sex, age groups, or different peaks. Notably, hospitalized patients exhibited prolonged PT and aPTT. Overall, 81.1% of patients recovered, while 18.9% succumbed to the disease.

CONCLUSION

This multicenter study provides valuable insights into the coagulation dynamics of COVID-19 patients, highlighting specific coagulation disorders associated with SARS-CoV-2. The findings emphasize the importance of monitoring coagulation markers for effective patient management and treatment decisions. Understanding how genetic and non-genetic factors influence outcomes is crucial for comprehensive care. Standardized data collection across centers strengthens the study's reliability.