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...

Full description

Saved in:

Bibliographic Details
Published in:	PloS one Vol. 17; no. 1; p. e0262600
Main Authors:	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
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 14-01-2022 Public Library of Science (PLoS)
Subjects:	Adult Aged Algorithms Analysis Biology and Life Sciences Blood Coagulation Clotting Coagulation Coronaviruses COVID-19 COVID-19 - blood COVID-19 - complications COVID-19 - diagnosis Decision trees Engineering and Technology Female Fibrinogen Health aspects Humans Longitudinal Studies Male Medicine and Health Sciences Middle Aged Parameters People and places Research and Analysis Methods SARS-CoV-2 - isolation & purification Severe acute respiratory syndrome coronavirus 2 Severity of Illness Index Thrombelastography Thromboembolism Thrombophilia - blood Thrombophilia - diagnosis Thrombophilia - etiology Young Adult Brazil
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 Competing Interests: The authors have declared that no competing interests exist. OAMF and LMHM also contributed equally to this work.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0262600