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Rotational thromboelastometry (ROTEM) profiling of COVID–19 patients

2021; Informa; Volume: 32; Issue: 5 Linguagem: Inglês

10.1080/09537104.2021.1881949

1369-1635

Mirjana Mitrović, Nikica Sabljić, Zorica Cvetković, Nikola Pantić, Aleksandra Zivkovic Dakic, Zoran Bukumirić, Vesna Libek, Nebojša Savić, Branislava Milenković, Marijana Virijević, Violeta Vučinić, Ivana Milošević, Zlatko Pravdić, Nada Suvajdžić, Jawed Fareed, Darko Antić,

Climate Change and Health Impacts

We evaluated coagulation abnormalities via traditional tests and rotational thromboelastometry (ROTEM) in a group of 94 patients with confirmed SARS-CoV-2 infection and different severity of pneumonia (34 moderate, 25 severe, 35 critical) with the hypothesis that ROTEM parameters differed by coronavirus disease 2019 (COVID-19) severity. Shorter than normal clotting time (CT) and higher than normal maximum clot firmness (MCF) in extrinsic rotational thromboelastometry (EXTEM) and fibrinogen rotational thromboelastometry (FIBTEM), shorter than normal EXTEM clot formation time (CFT), and higher than normal α-angle were classified as markers of hypercoagulable state. Increment in the number of patients with ≥2 hypercoagulable parameters, higher EXTEM (P = .0001), FIBTEM MCF (P = .0001) and maximum lysis decrement (P = .002) with increment in disease severity was observed (P = .0001). Significant positive correlations between IL6 and CT EXTEM (P = .003), MCF EXTEM (P = .033), MCF FIBTEM (P = .01), and negative with ML EXTEM (P = .006) were seen. Our findings based on analysis of different disease severity groups confirmed that a hypercoagulable ROTEM pattern characterized by clot formation acceleration, high clot strength, and reduced fibrinolysis was more frequent in advanced disease groups and patients with high IL6. These results supported the need for different thromboprophylaxis approaches for different severity groups.