Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention

被引:15
作者
Aires, Rodrigo B. [1 ,2 ]
Soares, Alexandre A. de S. M. [1 ]
Gomides, Ana Paula M. [3 ]
Nicola, Andre M. [1 ]
Teixeira-Carvalho, Andrea [4 ]
da Silva, Dayde Lane M. [5 ]
de Gois, Eliana T. [1 ,6 ]
Xavier, Flavia D. [1 ]
Martins, Francielle P. [1 ,7 ]
Santos, Gabriela P. J. [1 ,8 ]
Schulte, Heidi Luise [1 ]
Luz, Isabelle S. [9 ]
Espindola, Laila S. [1 ,10 ]
do Amaral, Laurence R. [11 ]
Felicori, Liza F. [12 ]
Naves, Luciana A. [1 ,13 ]
de Carvalho, Maira R. M. [1 ,14 ]
Gomes, Matheus de S. [11 ]
Nobrega, Otavio T. [1 ]
Albuquerque, Patricia [15 ]
Fontes, Wagner [9 ]
Gomes, Ciro M. [1 ,16 ]
Kurizky, Patricia S. [1 ,16 ]
Albuquerque, Cleandro P. [1 ,17 ]
Martins-Filho, Olindo A. [4 ]
da Mota, Licia Maria H. [1 ,17 ]
机构
[1] Univ Brasilia UnB, Fac Med, Programa Posgrad Ciencias Med, Brasilia, DF, Brazil
[2] Hosp Santa Lucia Sul, Serv Anestesiol, Brasilia, DF, Brazil
[3] Ctr Univ Brasilia, Fac Ciencias Saude, Brasilia, DF, Brazil
[4] Fiocruz MS, Fundacao Oswaldo Cruz, Grp Integrad Pesquisa Biomarcadores, Belo Horizonte, MG, Brazil
[5] Univ Brasilia UnB, Dept Farm, Brasilia, DF, Brazil
[6] Hosp Reg Gama HRG, Unidade Clin Med, Brasilia, DF, Brazil
[7] Hosp Reg Asa Norte HRAN, Nucleo Gestao Interna Leitos, Brasilia, DF, Brazil
[8] Hosp Reg Taguatinga, Unidade Med Interna, Brasilia, DF, Brazil
[9] Univ Brasilia UnB, Inst Ciencias Biol, Dept Biol Celular, Lab Bioquim & Quim Prot, Brasilia, DF, Brazil
[10] Univ Brasilia UnB, Fac Ciencias Saude, Lab Farmacognosia, Brasilia, DF, Brazil
[11] Univ Fed Uberlandia, Lab Bioinformat & Anal Mol, Rede Multidisciplinar Pesquisa Ciencia & Tecnol R, Patos De Minas, MG, Brazil
[12] Univ Fed Minas Gerais UFMG, Inst Ciencias Biol, Dept Bioquim & Imunol, Lab Biol Sintet & Biomimet, Belo Horizonte, MG, Brazil
[13] Univ Brasilia UnB, Hosp Univ Brasilia, Serv Endocrinol, Brasilia, DF, Brazil
[14] Hosp Reg Asa Norte HRAN, Unidade Med Interna, Brasilia, DF, Brazil
[15] Univ Brasilia UnB, Fac UnB Ceilandia, Brasilia, DF, Brazil
[16] Univ Brasilia UnB, Hosp Univ Brasilia, Serv Dermatol, Brasilia, DF, Brazil
[17] Univ Brasilia UnB, Hosp Univ Brasilia, Serv Reumatol, Brasilia, DF, Brazil
关键词
ROTATIONAL THROMBOELASTOMETRY;
D O I
10.1371/journal.pone.0262600
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
In patients with severe forms of COVID-19, thromboelastometry has been reported to display a hypercoagulant pattern. However, an algorithm to differentiate severe COVID-19 patients from nonsevere patients and healthy controls based on thromboelastometry parameters has not been developed. Forty-one patients over 18 years of age with positive qRT-PCR for SARS-CoV-2 were classified according to the severity of the disease: nonsevere (NS, n = 20) or severe (S, n = 21). A healthy control (HC, n = 9) group was also examined. Blood samples from all participants were tested by extrinsic (EXTEM), intrinsic (INTEM), non-activated (NATEM) and functional assessment of fibrinogen (FIBTEM) assays of thromboelastometry. The thrombodynamic potential index (TPI) was also calculated. Severe COVID-19 patients exhibited a thromboelastometry profile with clear hypercoagulability, which was significantly different from the NS and HC groups. Nonsevere COVID-19 cases showed a trend to thrombotic pole. The NATEM test suggested that nonsevere and severe COVID-19 patients presented endogenous coagulation activation (reduced clotting time and clot formation time). TPI data were significantly different between the NS and S groups. The maximum clot firmness profile obtained by FIBTEM showed moderate/elevated accuracy to differentiate severe patients from NS and HC. A decision tree algorithm based on the FIBTEM-MCF profile was proposed to differentiate S from HC and NS. Thromboelastometric parameters are a useful tool to differentiate the coagulation profile of nonsevere and severe COVID-19 patients for therapeutic intervention purposes.
引用
收藏
页数:19
相关论文
共 33 条
[11]   Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia [J].
Cui, Songping ;
Chen, Shuo ;
Li, Xiunan ;
Liu, Shi ;
Wang, Feng .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2020, 18 (06) :1421-1424
[12]  
Dimitrova-Karamfilova A., 2012, LIFE SCI, V6, P28
[13]   Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses [J].
Faul, Franz ;
Erdfelder, Edgar ;
Buchner, Axel ;
Lang, Albert-Georg .
BEHAVIOR RESEARCH METHODS, 2009, 41 (04) :1149-1160
[14]   Coagulation Dysfunction A Hallmark in COVID-19 [J].
Fei, Yang ;
Tang, Ning ;
Liu, Hefei ;
Cao, Wenjing .
ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE, 2020, 144 (10) :1223-1229
[15]   The role of rotational thromboelastometry during the COVID-19 pandemic: a narrative review [J].
Goerlinger, Klaus ;
Almutawah, Hawra ;
Almutawaa, Fatimah ;
Alwabari, Maryam ;
Alsultan, Zahra ;
Almajed, Jumanah ;
Alwabari, Mahmoud ;
Alsultan, Maryam ;
Shahwar, Duri ;
Yassen, Khaled Ahmed .
KOREAN JOURNAL OF ANESTHESIOLOGY, 2021, 74 (02) :91-102
[16]   COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps? [J].
Goerlinger, Klaus ;
Dirkmann, Daniel ;
Gandhi, Ajay ;
Simioni, Paolo .
ANESTHESIA AND ANALGESIA, 2020, 131 (05) :1324-1333
[17]  
Grlinger K., 2016, TRAUMA INDUCED COAGU, P267, DOI [10.1007/978-3-319-28308-1_18, 10.1007/978-3-319-28308-118, DOI 10.1007/978-3-319-28308-1_18]
[18]   Greater Fibrinolysis Resistance but No Greater Platelet Aggregation in Critically Ill COVID-19 Patients [J].
Heinz, Christoph ;
Miesbach, Wolfgang ;
Herrmann, Eva ;
Sonntagbauer, Michael ;
Raimann, Florian J. ;
Zacharowski, Kai ;
Weber, Christian F. ;
Adam, Elisabeth H. .
ANESTHESIOLOGY, 2021, 134 (03) :457-467
[19]   Rotational thromboelastometry predicts thromboembolic complications after major non-cardiac surgery [J].
Hincker, Alexander ;
Feit, Justin ;
Sladen, Robert N. ;
Wagener, Gebhard .
CRITICAL CARE, 2014, 18 (05)
[20]   Coagulopathy of Coronavirus Disease 2019 [J].
Iba, Toshiaki ;
Levy, Jerrold H. ;
Levi, Marcel ;
Connors, Jean Marie ;
Thachil, Jecko .
CRITICAL CARE MEDICINE, 2020, 48 (09) :1358-1364