More Severe Hypercoagulable State in Acute COVID-19 Pneumonia as Compared With Other Pneumonia

OBJECTIVE: To conduct a comprehensive evaluation of coagulation profiles—via traditional and whole blood thromboelastometry tests—in coronavirus disease 2019 (COVID-19)–positive vs COVID-19–negative patients admitted to medical wards for acute pneumonia. PATIENTS AND METHODS: We enrolled all consecutive patients admitted to internal medicine wards of Padova University Hospital between 7 March and 30 April, 2020, for COVID-19–related pneumonia (cases) vs non–COVID-19 pneumonia (controls). A group of healthy individuals acted as baseline for thromboelastometry parameters. RESULTS: Fifty-six cases (mean age, 64±15 years; male/female, 37/19) and 56 controls (mean age, 76±11 years; male/female, 35/21) were enrolled. Cases and controls exhibited markedly hypercoagulable thromboelastometry profiles vs healthy individuals, mainly characterized by a significantly shorter propagation phase of coagulation (clot formation time) and significantly increased maximum clot firmness (P<.001 for all comparisons). Patients with COVID-19 pneumonia had significantly shorter clot formation time and higher maximum clot firmness (P<.01 and P<.05, respectively, for all comparisons) than did controls. CONCLUSION: Patients admitted to internal medicine wards for COVID-19 pneumonia presented a markedly prothrombotic state, which seems peculiar to COVID-19 rather than pneumonia itself.