Abstract
BackgroundThere is emerging evidence for enhanced blood coagulation in coronavirus 2019 (COVID-19) patients, with thromboembolic complications contributing to morbidity and mortality. The mechanisms underlying this prothrombotic state remain enigmatic. Further data to guide anticoagulation strategies are urgently required.MethodsWe used viscoelastic rotational thromboelastometry (ROTEM) in a single-center cohort of 40 critically ill COVID-19 patients.ResultsClear signs of a hypercoagulable state due to severe hypofibrinolysis were found. Maximum lysis, especially following stimulation of the extrinsic coagulation system, was inversely associated with an enhanced risk of thromboembolic complications. Combining values for maximum lysis with D-dimer concentrations revealed high sensitivity and specificity of thromboembolic risk prediction.ConclusionsThe study identifies a reduction in fibrinolysis as an important mechanism in COVID-19-associated coagulopathy. The combination of ROTEM and D-dimer concentrations may prove valuable in identifying patients requiring higher intensity anticoagulation.
Highlights
There is emerging evidence for enhanced blood coagulation in coronavirus 2019 (COVID-19) patients, with thromboembolic complications contributing to morbidity and mortality
We report rotational thromboelastometry (ROTEM) data in 40 consecutive, severely ill COVID-19 patients treated in two tertiary intensive care units (ICUs) and assessed the association with thromboembolic complications
Characteristics of the cohort Forty consecutive patients with COVID-19 confirmed by polymerase chain reaction in throat swabs were admitted to two ICUs within our department between March 25th and May 11th
Summary
There is emerging evidence for enhanced blood coagulation in coronavirus 2019 (COVID-19) patients, with thromboembolic complications contributing to morbidity and mortality. The mechanisms underlying this pro‐ thrombotic state remain enigmatic. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has led to a global pandemic posing a major threat to humans [1]. There is emerging evidence that involvement of other pathomechanisms contributes to morbidity and mortality Both clinical and autopsy studies have revealed a high incidence of venous and arterial thromboembolic events, including pulmonary embolism, even in patients receiving therapeutic anticoagulation [5,6,7].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
