Abstract The outbreak of 2019 novel coronavirus disease (COVID‐19) has posed a grave threat to the global public health. The COVID‐19‐induced infection is closely related to coagulation dysfunction in the affected patients. This paper attempts to conduct a meta‐analysis and systematically review the blood coagulation indicators in patients with severe COVID‐19. A meta‐analysis of eligible studies was performed to compare the blood coagulation indicators in patients with severe and nonsevere COVID‐19. PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies published between 1 December 2019 and 7 May 2020. A total of 13 studies with 1341 adult patients were enrolled in this analysis. Platelet (weighted mean difference [WMD] = −24.83, 95% confidence interval [CI]: −34.12 to −15.54; P < .001), d‐dimer (WMD = 0.19, 95% CI: 0.09‐0.29; P < .001), and fibrinogen (WMD = 1.02, 95% CI: 0.50‐1.54; P < .001) were significantly associated with the severity in patients with COVID‐19. The meta‐analysis revealed that no correlation was evident between an increased severity risk of COVID‐19 and activated partial thromboplastin time (WMD = −1.56, 95% CI: −5.77 to 2.64; P = .468) or prothrombin time (WMD = 0.19, 95% CI: −0.13 to 0.51; P = .243). The single arm meta‐analysis showed that compared with the nonsevere group, the severe group had a lower pooled platelet (165.12 [95% CI: 157.38‐172.85] vs 190.09 [95% CI: 179.45‐200.74]), higher d‐dimer (0.49 [95% CI: 0.33‐0.64] vs 0.27 [95% CI: 0.20‐0.34]), and higher fibrinogen (4.34 [95% CI: 1.98‐6.70] vs 3.19 [95% CI: 1.13‐5.24]). Coagulation dysfunction is closely related to the severity of patients with COVID‐19, in which low platelet, high d‐dimer, and fibrinogen upon admission may serve as risk indicators for increased aggression of the disease. These findings are of great clinical value for timely and effective treatment of the COVID‐19 cases. Highlights Coagulation dysfunction affects the prognosis of COVID‐19 patients. Lower platelet, higher d‐dimer and fibrinogen indicate increased severity risk in COVID‐19 patients. No difference in PT and APTT is evident between severe and non‐severe COVID‐19 patients upon admission.
【저자키워드】 2019 novel coronavirus disease, severity, meta‐analysis, Coagulation, 【초록키워드】 Treatment, Prognosis, Infection, risk, Blood coagulation, COVID‐19, 2019 novel coronavirus, outbreak, Patient, Platelet, fibrinogen, disease, Admission, patients, Analysis, Prothrombin time, coagulation dysfunction, dysfunction, Web of Science, 95% confidence interval, COVID‐19 patients, global public health, severe group, aPTT, Cochrane Library, mean difference, no correlation, Lower, aggression, Affect, effective, enrolled, affected, significantly, the disease, was performed, activated, searched, COVID‐19 patient, eligible, 【제목키워드】 systematic review, COVID‐19, coagulation dysfunction,