The Composition and Physical Properties of Clots in COVID-19 Pathology

Abstract

Hemostasis is a finely tuned process of which dysregulation can lead either to bleeding or thrombotic complications. The latter is often caused by the hypercoagulable state as it is also seen in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, i.e., in COVID-19 patients. COVID-19 patients requiring hospitalization often suffer from thrombotic events that could not be predicted using routine coagulation assays. Recently, several studies have reported ROtational ThromboElastoMetry (ROTEM) as a promising tool to predict outcomes in COVID-19 patients. In this review we give an overview of ROTEM with a particular focus on the interpretation of the symmetrical clot formation curve in relation to coagulopathy in COVID-19 patients. Furthermore, we have introduced new parameters that might help to better distinguish between COVID-19 patients and outcomes.

Trabajos libres, CADECI 2023

“…Por lo que es importante integrar a programas de rehabilitación cardiaca a pacientes con lesiones complejas no revascularizados. que la de las extremidades superiores y es más probable que provoque la pérdida de la extremidad (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Dominic y cols.…”

A systematic review and comparison of automated tools for quantification of fibrous networks

“…Fibrin is the main structural component of the thrombus that forms upon blood clotting. Structural properties of fibrin are important determinants of the disease burden and mortality associated with various diseases, such as cardiovascular disease and inflammatory diseases such as COVID-19 [13][14][15] . The fibrin network forms after activation of the coagulation cascade, ultimately leading to the cleavage of fibrinogen molecules into fibrin monomers that laterally and longitudinally associate into thick fibers that form branched networks 16 .…”

Reply to Bareille et al. Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on “Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices. J. Clin. Med. 2022, 11, 860”

“…During the pandemic, clinicians who relied on an evidence-based medicine approach were forced to practice with evolving data concerning the escalation of anticoagulation in the COVID-19 patients who clearly presented with a very high rate of thrombosis [ 57 ]. Therefore, during this early period of the pandemic without the benefit of RCTs many institutions and hematologic societies provided diverse and evolving guidelines regarding the escalation of prophylactic anticoagulation to intermediate or therapeutic doses of heparin for patients with COVID-19 pneumonitis without macrovascular thrombosis, often relying on VHAs to assist in guiding the anticoagulation of these patients who, as we stated, would “clot and bleed at the same time” [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ].…”