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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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Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759688/
https://www.ncbi.nlm.nih.gov/pubmed/35030224
http://dx.doi.org/10.1371/journal.pone.0262600
Descripción
Sumario: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.