Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention

In patients with severe forms of COVID-19, thromboelastometry has been reported to display a hypercoagulant pattern. However, an algorithm to differentiate severe COVID-19 patients from nonsevere patients and healthy controls based on thromboelastometry parameters has not been developed. Forty-one p...

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Veröffentlicht in:PloS one 2022-01, Vol.17 (1), p.e0262600-e0262600
Hauptverfasser: Aires, Rodrigo B, Soares, Alexandre A de S M, Gomides, Ana Paula M, Nicola, André M, Teixeira-Carvalho, Andréa, da Silva, Dayde Lane M, de Gois, Eliana T, Xavier, Flávia D, Martins, Francielle P, Santos, Gabriela P J, Schulte, Heidi Luise, Luz, Isabelle S, Espindola, Laila S, do Amaral, Laurence R, Felicori, Liza F, Naves, Luciana A, de Carvalho, Maíra R M, Gomes, Matheus de S, Nóbrega, Otávio T, Albuquerque, Patrícia, Fontes, Wagner, Gomes, Ciro M, Kurizky, Patricia S, Albuquerque, Cleandro P, Martins-Filho, Olindo A, da Mota, Licia Maria H
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Sprache:eng
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Zusammenfassung:In patients with severe forms of COVID-19, thromboelastometry has been reported to display a hypercoagulant pattern. However, an algorithm to differentiate severe COVID-19 patients from nonsevere patients and healthy controls based on thromboelastometry parameters has not been developed. Forty-one patients over 18 years of age with positive qRT-PCR for SARS-CoV-2 were classified according to the severity of the disease: nonsevere (NS, n = 20) or severe (S, n = 21). A healthy control (HC, n = 9) group was also examined. Blood samples from all participants were tested by extrinsic (EXTEM), intrinsic (INTEM), non-activated (NATEM) and functional assessment of fibrinogen (FIBTEM) assays of thromboelastometry. The thrombodynamic potential index (TPI) was also calculated. Severe COVID-19 patients exhibited a thromboelastometry profile with clear hypercoagulability, which was significantly different from the NS and HC groups. Nonsevere COVID-19 cases showed a trend to thrombotic pole. The NATEM test suggested that nonsevere and severe COVID-19 patients presented endogenous coagulation activation (reduced clotting time and clot formation time). TPI data were significantly different between the NS and S groups. The maximum clot firmness profile obtained by FIBTEM showed moderate/elevated accuracy to differentiate severe patients from NS and HC. A decision tree algorithm based on the FIBTEM-MCF profile was proposed to differentiate S from HC and NS. Thromboelastometric parameters are a useful tool to differentiate the coagulation profile of nonsevere and severe COVID-19 patients for therapeutic intervention purposes.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0262600