Assessment of the Natural Anticoagulants (Protein C, Protein S, and Antithrombin III) for COVID-19 Patients

Background: COVID-19 was declared a pandemic at the end of 2019. The clinical manifestations diversified from minor non-specific symptoms to respiratory failure and even death. Infection leads to micro-thrombosis, hypercoagulability, and in some patients, large vessel thrombosis.Objective: To estimate natural anti-coagulants (protein S, antithrombin antithrombin III (ATIII), and protein C) in COVID-19 patients at the time of diagnosis and correlate our findings with the hypercoagulable state and prognosis of patients.Methodology: This study was performed on 100 patients were divided into 2 groups: 75 confirmed COVID-19 patients, and 25 pulmonary embolism (PE) patients. Patients were undergone some laboratory tests like PCR, Hemostatic status evaluation, serum ferritin, C reactive protein (CRP), LDH, and Complete Blood Count.Results: In the PE group the values of D-dimer, total leucocytic count, PT, and fibrinogen were significantly higher than COVID-19 group (P < 0.05). While in the COVID-19 group the values of protein C, and LDH were significantly higher than PE group (P < 0.05) and there was an insignificant difference between both groups regarding values of neutrophils, monocytes, platelets, CRP, ferritin, aPTT, ATIII, or protein S. Conclusion: ATIII, protein S, and protein C lower levels significantly affect the COVID-19 patients' severity and mortality.