COVID-19 (
coronavirus disease 2019) patients often show excessive activation of coagulation, associated with increased risk of
thrombosis. However, the diagnostic value of coagulation at initial clinical evaluation is not clear. We present an in-depth analysis of coagulation in patients presenting to the emergency department (ED) with suspected
COVID-19. N = 58 patients with clinically suspected
COVID-19 in the ED were enrolled. N = 17 subsequently tested positive using SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction (PCR) swabs, while in n = 41
COVID-19 was ruled-out. We analyzed both standard and extended coagulation parameters, including
thromboplastin time (INR), activated partial thromboplastin time (aPTT),
antithrombin,
plasminogen,
plasminogen activator inhibitor-1 (PAI-1), D-dimers, and
fibrinogen at admission, as well as α2-antiplasmin,
activated protein C -resistance,
factor V,
lupus anticoagulant,
protein C,
protein S, and von Willebrand diagnostics. These data, as well as mortality and further laboratory parameters, were compared across groups based on
COVID-19 diagnosis and severity of disease. In patients with
COVID-19, we detected frequent clotting abnormalities, including D-dimers. The comparison cohort in the ED, however, showed similarly altered coagulation. Furthermore, parameters previously shown to distinguish between severe and moderate
COVID-19 courses, such as platelets,
plasminogen,
fibrinogen, aPTT, INR, and
antithrombin, as well as multiple nonroutine coagulation analytes showed no significant differences between patients with and without
COVID-19 when presenting to the ED. At admission to the ED the prevalence of coagulopathy in patients with
COVID-19 is high, yet comparable to the non-COVID-19 cohort presenting with respiratory symptoms. Nevertheless, coagulopathy might worsen during
disease progression with the need of subsequent risk stratification.