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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization

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Utility of Thromboelastography and velocity curve derivative in diagnosing COVID-19 associated coagulopathy

Ganesh Mohan1, William Wilson2, Bemma Paonam3

  • 1Department of Immunohematology and Blood Transfusion, Benign Hematological Disorders Centre, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

International Journal of Laboratory Hematology
|May 24, 2022
PubMed

Insights

Thromboelastography (TEG) and its velocity curve (V-curve) effectively diagnose COVID-19 associated coagulopathy (CAC). This hypercoagulable state increases risks of thromboembolism and mortality, as shown by TEG analysis in severe COVID-19 patients.

Area of Science:

  • Critical care medicine
  • Hematology
  • Infectious diseases

Background:

  • COVID-19 associated coagulopathy (CAC) presents a significant risk for thromboembolism.
  • Understanding the hypercoagulable state in COVID-19 is crucial for patient management.

Purpose of the Study:

  • To evaluate the utility of Thromboelastography (TEG) in diagnosing CAC.
  • To assess the role of TEG's velocity curve (V-curve) in differentiating CAC stages.

Main Methods:

  • Prospective cohort study of RT-PCR confirmed severe COVID-19 patients.
  • Citrated kaolin TEG performed on admission, analyzing parameters like R time, K time, alpha angle, maximum amplitude, clotting index, and lysis at 30 min.
  • Velocity curve (V-curve) derivative analyzed for thrombus generation potential, maximum rate, and total thrombus generated (TG).

Main Results:

  • All 43 patients exhibited hypercoagulable TEG and V-curve results.
  • 79.06% of patients were in a hypercoagulable state; mortality was 32.56%, with 30.23% experiencing thrombotic events.
  • Non-survivors showed prolonged PT, aPTT, MA, Ly30, and reduced TG (p < .05); fibrinolysis correlated with thromboembolism (OR = 6.76).

Conclusions:

  • TEG is a valuable diagnostic tool for COVID-19 associated coagulopathy.
  • TEG and V-curve analysis aid in categorizing the severity and stages of CAC.
  • Findings highlight the persistent hypercoagulable state and increasing fibrinolysis in severe COVID-19.
Abstract

Keywords:
COVID-19Thromboelastographycoagulopathyfibrinolysismortalitythromboembolismviscoelastic tests

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