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Thromboelastography findings in critically ill COVID-19 patients.

Authors
  • Salem, Nouran1
  • Atallah, Bassam1, 2
  • El Nekidy, Wasim S1, 2
  • Sadik, Ziad G1
  • Park, Woosup Michael3
  • Mallat, Jihad4, 5, 6
  • 1 Department of Pharmacy, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. , (United Arab Emirates)
  • 2 Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • 3 Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. , (United Arab Emirates)
  • 4 Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA. [email protected]
  • 5 Critical Care Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, PO Box 112412, Abu Dhabi, United Arab Emirates. [email protected] , (United Arab Emirates)
  • 6 Normandy University, UNICAEN, ED 497, Caen, France. [email protected] , (France)
Type
Published Article
Journal
Journal of Thrombosis and Thrombolysis
Publisher
Springer-Verlag
Publication Date
May 01, 2021
Volume
51
Issue
4
Pages
961–965
Identifiers
DOI: 10.1007/s11239-020-02300-7
PMID: 33011896
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The rate of venous and arterial thrombotic events among patients infected with severe acute respiratory syndrome coronavirus-2 (SAR-CoV-2) is high. This may be due to a hypercoagulable state induced by the severe inflammation that results from the SAR-CoV-2 infection. We aimed to determine hypercoagulable states' incidence based on thromboelastography study and its association with thrombotic events in critically ill patients with coronavirus disease 2019 (COVID-19). Fifty-two COVID-19 patients who had thromboelastography study were retrospectively included. All patients received pharmacologic thromboprophylaxis. The hypercoagulable state was observed in 16 patients (30.8%). Among them, maximum amplitude and a-angle were elevated in 75% and 25%, respectively. Reaction time and K were low in only 12.5% for both of them. Inflammatory and coagulation markers, as well as thromboprophylaxis regimens, were not associated with a hypercoagulable state. Fourteen patients (27%) experienced a total of 16 thrombotic events, including 8 (57%) deep venous thrombosis, 6 (43%) pulmonary embolism, and 2 (14.3%) arterial thrombosis. The hypercoagulable state was not significantly associated with thrombotic events. In summary, we observed a lower rate of hypercoagulable state on thromboelastography study in critically ill COVID-19 patients. Also, the hypercoagulable state was not associated with the occurrence of thrombotic events.

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