COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure

Abstract In late December 2019 an outbreak of a novel coronavirus (SARS-CoV-2) causing severe pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China. A common finding in most COVID-19 patients is high D-dimer levels which are associated with a worse prognosis. We aimed to evaluate coagula...

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Bibliographic Details
Published in:Thrombosis and haemostasis Vol. 120; no. 6; pp. 998 - 1000
Main Authors: Spiezia, Luca, Boscolo, Annalisa, Poletto, Francesco, Cerruti, Lorenzo, Tiberio, Ivo, Campello, Elena, Navalesi, Paolo, Simioni, Paolo
Format: Journal Article
Language:English
Published: Stuttgart · New York Georg Thieme Verlag KG 01.06.2020
Subjects:
Acute Disease
Aged
Area Under Curve
Betacoronavirus
Blood Coagulation
Blood Coagulation Tests
Coronavirus Infections - blood
Coronavirus Infections - complications
Coronavirus Infections - therapy
COVID-19
Critical Care
Female
Fibrin - analysis
Fibrin Fibrinogen Degradation Products - analysis
Fibrinogen - analysis
Humans
Intensive Care Units
Italy - epidemiology
Letter to the Editor
Male
Middle Aged
Pandemics
Pneumonia, Viral - blood
Pneumonia, Viral - complications
Pneumonia, Viral - therapy
Prognosis
Respiration Disorders - complications
Respiration Disorders - therapy
SARS-CoV-2
Thrombelastography
Thrombophilia - complications
Treatment Outcome
Italy
thrombotic complications
thromboelastometry
fibrinogen/fibrin
ISSN:0340-6245, 2567-689X, 2567-689X
Online Access:Get full text
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Summary:Abstract In late December 2019 an outbreak of a novel coronavirus (SARS-CoV-2) causing severe pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China. A common finding in most COVID-19 patients is high D-dimer levels which are associated with a worse prognosis. We aimed to evaluate coagulation abnormalities via traditional tests and whole blood thromboelastometry profiles in a group of 22 (mean age 67 ± 8 years, M:F 20:2) consecutive patients admitted to the Intensive Care Unit of Padova University Hospital for acute respiratory failure due to COVID-19. Cases showed significantly higher fibrinogen and D-dimer plasma levels versus healthy controls ( p  < 0.0001 in both comparisons). Interestingly enough, markedly hypercoagulable thromboelastometry profiles were observed in COVID-19 patients, as reflected by shorter Clot Formation Time (CFT) in INTEM ( p  = 0.0002) and EXTEM ( p  = 0.01) and higher Maximum Clot Firmness (MCF) in INTEM, EXTEM and FIBTEM ( p  < 0.001 in all comparisons). In conclusion, COVID-19 patients with acute respiratory failure present a severe hypercoagulability rather than consumptive coagulopathy. Fibrin formation and polymerization may predispose to thrombosis and correlate with a worse outcome.
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ISSN:0340-6245
2567-689X
2567-689X
DOI:10.1055/s-0040-1710018