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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Thromb+J 2021 ; 19 (1): 10 Nephropedia Template TP
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Pathological findings in rotation thromboelastometry associated with thromboembolic events in COVID-19 patients #MMPMID33573670
Boss K; Kribben A; Tyczynski B
Thromb J 2021[Feb]; 19 (1): 10 PMID33573670show ga
BACKGROUND: Severe thromboembolic events are one of the major complications associated with COVID-19 infection, especially among critically ill patients. We analysed ROTEM measurements in COVID-19 patients with a severe disease course and in patients with severe sepsis. METHODS: In this study, data obtained by extended analysis of haemostasis with standard laboratory tests and thromboelastometry of 20 patients with severe course of COVID-19 were retrospectively analysed and compared with similar data from 20 patients with severe sepsis but no COVID-19. RESULTS: The thromboelastometry values obtained from 20 sepsis patients contained a maximum clot firmness above the normal range but among COVID-19 patients, hypercoagulability was much more pronounced, with significantly higher maximum clot firmness (FIBTEM: 38.4 +/- 10.1 mm vs. 29.6 +/- 10.8 mm; P = 0.012; EXTEM: 70.4 +/- 10.4 mm vs. 60.6 +/- 14.8 mm; P = 0.022). Additionally, fibrinogen levels were significantly higher among COVID-19 patients (757 +/- 135 mg/dl vs. 498 +/- 132 mg/dl, P < 0.0001). Furthermore, thromboelastometry showed fibrinolysis shutdown among COVID-19 patients with significantly lower maximum of lysis than among sepsis patients (EXTEM: 0.6 +/- 1.2 % vs. 3.3 +/- 3.7 %; P = 0.013). Seven of 20 COVID-19 patients experienced thromboembolic events, whereas no patient in the sepsis group experienced such events. CONCLUSIONS: ROTEM analysis showed significantly different pathological findings characterized by hypercoagulability and fibrinolysis shutdown among COVID-19 patients with a severe disease course compared to patients with severe sepsis. These abnormalities seem to be associated with thromboembolic events.