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Inference from longitudinal laboratory tests characterizes temporal evolution of COVID-19-associated coagulopathy (CAC)

Aug 17 2020

Temporal inference from laboratory testing results and triangulation with clinical outcomes extracted from unstructured electronic health record (EHR) provider notes is integral to advancing precision medicine. Here, we studied 246 SARS-CoV-2 PCR-positive (COVIDpos) patients and propensity-matched 2460 SARS-CoV-2 PCR-negative (COVIDneg) patients subjected to around 700,000 lab tests cumulatively across 194 assays. Compared to COVIDneg patients at the time of diagnostic testing, COVIDpos patients tended to have higher plasma fibrinogen levels and lower platelet counts. However, as the infection evolves, COVIDpos patients distinctively show declining fibrinogen, increasing platelet counts, and lower white blood cell counts. Augmented curation of EHRs suggests that only a minority of COVIDpos patients develop thromboembolism, and rarely, disseminated intravascular coagulopathy (DIC), with patients generally not displaying platelet reductions typical of consumptive coagulopathies. These temporal trends provide fine-grained resolution into COVID-19 associated coagulopathy (CAC) and set the stage for personalizing thromboprophylaxis.

Authors:

Colin Pawlowski, Tyler Wagner, Arjun Puranik, Karthik Murugadoss, Liam Loscalzo, Rajiv K. Pruthi, Damon E Houghton, John C. O’Horo, William G. Morice II, Amy W Williams, Gregory J Gores, John Halamka ,Andrew D. Badley, Elliot S. Barnathan, Hideo Makimura, Najat Khan, Venky Soundararajan

nference, Cambridge, MA 02142 Mayo Clinic, Rochester, MN 55905 Mayo Clinic Laboratories, Rochester, MN 55905 Mayo Clinic Platform, Rochester, MN 55905 Janssen pharmaceutical companies of Johnson & Johnson (J&J), Spring House, United States

Mayo Clinic

nference

Janssen

Correspondence to:

Venky Soundararajan (venky@nference.net)

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