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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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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
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author 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.
author_facet 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.
author_sort Aires, Rodrigo B.
collection PubMed
description 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.
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spelling pubmed-87596882022-01-15 Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention 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. PLoS One Research Article 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. Public Library of Science 2022-01-14 /pmc/articles/PMC8759688/ /pubmed/35030224 http://dx.doi.org/10.1371/journal.pone.0262600 Text en © 2022 Aires et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
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.
Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title_full Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title_fullStr Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title_full_unstemmed Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title_short Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention
title_sort thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe covid-19 patients and has applicability as a decision algorithm for intervention
topic Research Article
url 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
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