Evaluation of the prothrombin fragment 1.2 in patients with coronavirus disease 2019 ( COVID ‐19)

Introduction Coronavirus disease 2019 (COVID‐19) may cause a hypercoagulable state. The D‐dimer is frequently elevated in COVID‐19, but other markers of coagulation activation, including the prothrombin fragment 1.2 (PF1.2) are poorly described. Methods We studied hospitalized adults with COVID‐19 and PF1.2 measurement performed at any time during hospitalization. We evaluated the relationship between PF1.2 and synchronously measured D‐dimer. We utilized receiver operating characteristic (ROC) analysis to evaluate optimal thresholds for diagnosing thrombosis and multivariable logistic regression to evaluate association with thrombosis. Results 115 patients were included [110 (95.7%) critically ill]. PF1.2 and D‐dimer were moderately positively correlated (r=0.542, P523 pmol/L: 69.2% sensitivity, 67.7% specificity; >924 pmol/L: 37.9% sensitivity, 87.8% specificity). In multivariable analysis, a PF1.2 >500 pmol/L was significantly associated with VTE [adjusted odds ratio (OR) 4.26, 95% CI, 1.12‐16.21, P=0.034] and any thrombotic manifestation (adjusted OR 3.85, 95% CI, 1.39‐10.65, P=0.010); conversely, synchronously measured D‐dimer was not significantly associated with thrombosis. 90.6% of patients with a non‐elevated PF1.2 result did not develop VTE. Conclusions PF1.2 may be a useful assay, and potentially more discriminant than D‐dimer, in identifying thrombotic manifestations in hospitalized patients with COVID‐19. This article is protected by copyright. All rights reserved.