Data published by haematologists from Wuhan, China indicates that abnormal coagulation parameters can be a useful predictor of prognosis in pneumonia due to COVID-19 (Tang et al, 2020). Although the numbers in this study are small, the results demonstrate that 71% of non-survivors had overt disseminated intravascular coagulation (DIC), as demonstrated by the International Society on Thrombosis and Haemostasis (ISTH) DIC score, compared with only 0.6% of survivors. The DIC score is calculated from measurement of the platelet count, D-dimer, fibrinogen and prothrombin time (Taylor et al, 2001) as shown in this table:
Parameter | Score |
Platelet Count | |
>100 x 109/L | 0 |
50-100 x 109/L | 1 |
<50 x 109/L | 2 |
D-dimer | |
No increase | 0 |
Moderate increase (1 – 10 times upper limit of normal) | 2 |
Strong increase (> 10 times upper limit of normal) | 3 |
Fibrinogen | |
> 1.0 g/L | 0 |
≤ 1.0 g/L | 1 |
Prothrombin time prolongation | |
< 3 s | 0 |
3 – 6 s | 1 |
> 6 s | 2 |
Overt Disseminated Intravascular Coagulation | ≥ 5 |
Specimen Labelling Procedure