Hypercoagulation Detected by Rotational Thromboelastometry Predicts Mortality in COVID-19: A Risk Model Based on a...

Area of Science:

• * Medicine
• * Critical Care
• * Hematology

Background:

• * Severe COVID-19 is linked to hypercoagulation.
• * Coagulopathy assessment in hospitalized COVID-19 patients is crucial.
• * Rotational Thromboelastometry (ROTEM) is explored as a diagnostic marker.

Purpose of the Study:

• * To evaluate ROTEM as a marker for coagulopathy in hospitalized COVID-19 patients.
• * To develop a prediction model for 30-day mortality using ROTEM parameters.
• * To investigate the association between hypercoagulation and COVID-19 severity.

Main Methods:

• * Prospective, observational study of 141 hospitalized COVID-19 patients.
• * Conventional coagulation tests and ROTEM (including EXTEM-MCF) were performed.
• * A logistic regression model predicted 30-day mortality using ROTEM, age, and respiratory frequency.

Main Results:

• * 18% of patients died within 30 days.
• * Increased EXTEM-MCF, age, and respiratory frequency predicted higher mortality risk.
• * Longitudinal ROTEM data indicated enhanced hypercoagulation in severely ill patients.
• * In vitro analysis suggested a direct SARS-CoV-2 effect on coagulation initiation, independent of heparin.

Conclusions:

• * ROTEM-measured hypercoagulation predicts 30-day mortality in COVID-19.
• * Hypercoagulation is a significant factor in severe COVID-19 disease progression.
• * ROTEM shows potential as a tool for assessing COVID-19 severity and guiding treatment.