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  • Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis #MMPMID32302438
  • Panigada M; Bottino N; Tagliabue P; Grasselli G; Novembrino C; Chantarangkul V; Pesenti A; Peyvandi F; Tripodi A
  • J Thromb Haemost 2020[Jul]; 18 (7): 1738-1742 PMID32302438show ga
  • BACKGROUND: The severe inflammatory state secondary to COVID-19 leads to a severe derangement of hemostasis that has been recently described as a state of disseminated intravascular coagulation (DIC) and consumption coagulopathy, defined as decreased platelet count, increased fibrin(ogen) degradation products such as D-dimer, as well as low fibrinogen. AIMS: Whole blood from 24 patients admitted at the intensive care unit because of COVID-19 was collected and evaluated with thromboelastography by the TEG point-of-care device on a single occasion and six underwent repeated measurements on two consecutive days for a total of 30 observations. Plasma was evaluated for the other parameters of hemostasis. RESULTS: TEG parameters are consistent with a state of hypercoagulability as shown by decreased values, and increased values of K angle and MA. Platelet count was normal or increased, prothrombin time and activated partial thromboplastin time were near(normal). Fibrinogen was increased and D-dimer was dramatically increased. C-reactive protein was increased. Factor VIII and von Willebrand factor (n = 11) were increased. Antithrombin (n = 11) was marginally decreased and protein C (n = 11) was increased. CONCLUSION: The results of this cohort of patients with COVID-19 are not consistent with acute DIC, rather they support hypercoagulability together with a severe inflammatory state. These findings may explain the events of venous thromboembolism observed in some of these patients and support antithrombotic prophylaxis/treatment. Clinical trials are urgently needed to establish the type of drug, dosage, and optimal duration of prophylaxis.
  • |*Blood Coagulation[MESH]
  • |*Intensive Care Units[MESH]
  • |*Thrombelastography[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Betacoronavirus/*pathogenicity[MESH]
  • |Biomarkers/blood[MESH]
  • |Case-Control Studies[MESH]
  • |Coronavirus Infections/blood/*diagnosis/virology[MESH]
  • |Host-Pathogen Interactions[MESH]
  • |Humans[MESH]
  • |Inflammation Mediators/blood[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/blood/*diagnosis/virology[MESH]
  • |Predictive Value of Tests[MESH]
  • |Thrombophilia/blood/*diagnosis/virology[MESH]
  • |Young Adult[MESH]

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  • suck abstract from ncbi

    1738 7.18 2020