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Thromboelastography demonstrates progressive hypercoagulability in COVID-19 patients admitted to ICU with respiratory

Kunal Joshi1, Jeremy Fabes1, Clare Melikian2

  • 1Royal Free London NHS Foundation Trust, London, UK.

Journal of the Intensive Care Society
|February 8, 2023
PubMed

Insights

COVID-19 patients show mixed coagulation changes, with functional fibrinogen differences emerging after ICU admission. Targeting fibrinogen or platelets may help prevent blood clots in these patients.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Infectious Diseases

Background:

  • COVID-19 is linked to thromboembolic events due to a hypercoagulable state.
  • While elevated fibrinogen and D-dimers are common, other factors contribute to COVID-19 hypercoagulability.

Purpose of the Study:

  • To compare coagulation parameters between COVID-19 and non-COVID-19 ICU patients with respiratory failure.
  • To investigate differences in thromboelastography findings in these patient groups.

Main Methods:

  • Prospective observational study from April 2020 to June 2020.
  • Thromboelastography was used to analyze coagulation in COVID-19 and non-COVID-19 intensive care unit (ICU) patients.
  • Coagulation parameters, including functional fibrinogen (CFF) and Clauss fibrinogen, were compared.

Main Results:

  • Significant differences in functional fibrinogen (CFF) were observed between COVID-19 and non-COVID-19 patients from the third ICU day onwards.
  • No significant difference was found in Clauss fibrinogen levels between the groups.
  • COVID-19 patients exhibited supranormal R time, suggesting hypocoagulability.

Conclusions:

  • Mixed coagulation changes, including potential hypocoagulability, are present in COVID-19 patients.
  • Targeting fibrinogen or platelets may be a strategy to mitigate thromboembolic complications in COVID-19.
  • Further research is warranted to explore therapeutic interventions for COVID-19-associated coagulopathy.

Keywords:
COVID-19Thromboelastography

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