Thromboelastography Profile of Patients with COVID-19 Admitted to Intensive Care Unit: A Single-center Retrospective Study from India

Saseedharan, Sanjith; Talla, Vijay B; Chiluka, Annapurna

doi:10.5005/jp-journals-10071-23675

Cited by 9 publications

(19 citation statements)

References 24 publications

(22 reference statements)

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“…Most TEG studies did not find an association between TEG abnormalities and thrombotic events. 6,22 Similar to our results, a study by Saseedharan et al 27 found hypercoagulability in 62.5% of their 32 ICU patients, based on CI.…”

Section: Discussionsupporting

confidence: 91%

Thromboelastography determined dynamics of blood coagulation and its correlation with complications and outcomes in patients with coronavirus disease 2019

Sehgal

Aggarwal

Baitha

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background Coronavirus disease 2019 (COVID‐19) causes abnormalities in the hemostatic system, collectively known as COVID‐associated coagulopathy. The dynamics of clot formation are best discerned by whole‐blood viscoelastic tests, such as thromboelastography (TEG). We aimed to assess the various abnormalities seen on TEG and explored the predictors of outcomes in these patients. Methods Thromboelastography was performed for 28 patients with COVID‐19 using an automated thromboelastogram. The hemostatic condition was categorized as hypercoagulable in 17 (63%), hypocoagulable in 2 (7%), and normal in 8 (30%) based on TEG variables, such as reaction time , time until clot reaches a fixed strength, alpha angle, maximum amplitude, and clotting index. Laboratory parameters and clinical outcomes were compared between hypercoagulable and normal groups. Results Twenty‐seven patients with a median age of 50 years (interquartile range, 40‐60 years), male‐to‐female ratio of 0.9:1, median C‐reactive protein of 25.7 (10.9‐108.8) mg/L, serum ferritin of 693 (317‐1031) µg/L, and albumin 2.9 (2.6‐3.3) g/dL were included. The median prothrombin time/international normalized ratio and activated partial thromboplastin time were within normal range in the hypercoagulable and normal groups. The severity of COVID‐19 was mild in 6 (22.2%), moderate in 2 (7.4%), and severe in 19 (70.4%) patients. Twenty‐eight‐day mortality among patients with hypocoagulable and hypercoagulable states was higher than normal coagulation status. (log‐rank test, P = .002). Conclusions Hypercoagulable state, together with a severe inflammatory state, is common in patients with COVID‐19, despite thromboprophylaxis. TEG assesses coagulation status better than conventional coagulation tests. Coagulation abnormalities are associated with poor outcomes.

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Section: Discussionsupporting

confidence: 91%

Thromboelastography determined dynamics of blood coagulation and its correlation with complications and outcomes in patients with coronavirus disease 2019

Sehgal

Aggarwal

Baitha

et al. 2022

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

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“…These studies were carried out in patients diagnosed with severe COVID-19 and followed up in the intensive care unit [3,4,[7][8][9]. The design of our research is entirely different from previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Evaluation of the coagulation status may be crucial for the disease prognosis. Thromboelastography (TEG) is a test that evaluates clot formation and fibrinolysis in real-time, unlike conventional coagulation tests [6,7]. Because of this, TEG can help detect thromboembolic events in the patient.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Coagulation with TEG in Patients Diagnosed COVID-19

Vatansev¹,

Karaselek²,

Yılmaz³

et al. 2021

Turk J Med Sci

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Background and aim A high D-dimer level may indicate the risk of coagulopathy and mortality in COVID-19 patients. Thromboelastography (TEG) is a test that evaluates clot formation and fibrinolysis in real-time, unlike routine coagulation tests. The study aimed to investigate the coagulation process with TEG in patients diagnosed with COVID-19. Materials and Methods The study was performed at our university hospital, chest diseases outpatient clinic as a cross-section study. A total of 51 patients with 23 high D-dimer levels group (HDG) and 28 low D-dimers group (LDG) were included in the study. TEG analysis was performed at the pretreatment evaluation in these two groups. Results D-dimer and fibrinogen levels of the HDG were higher than those of the LDG (550 vs. 90 ng/mL, p < 0.001; 521 vs. 269 mg/dL, p < 0.001, respectively). In TEG analysis, HDG’s R and K values were lower than LDG, and HDG’s Angle, MA, and CI values were higher than LDG (p = 0.037; p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). ROC curve analysis suggested that the optimum TEG parameters cut-off points for thrombosis risk were as below: for K was ≤2.1 min, for R was ≤6.1 min, for Angle was >62°, MA was 60.4 mm. Conclusion Our study showed that the risk of thrombosis might increase in COVID-19 patients who are not hospitalized in the intensive care unit. Thrombosis risk should be investigated with TEG analysis and laboratory tests in every patient diagnosed with COVID-19, and treatment should be started for risky patients.

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“…Recently, Mitrovic et al [ 104 ], basing on ROTEM analysis of different severity of disease, observed that a hypercoagulable state characterized by clot formation acceleration, high clot strength and reduced fibrinolysis, was more frequent in advanced disease patients and patients with high interleukin-6. An Indian retrospective study, using TEG analysis, confirmed the presence of hypercoagulability that was more pronounced in severe forms of COVID-19 patients admitted to ICU [ 105 ].…”

Section: Care Level In Covid-19 Patients: What Can We Learn From the Vets?mentioning

confidence: 97%

Questions about COVID-19 associated coagulopathy: possible answers from the viscoelastic tests

Pavoni¹,

Gianesello

Pazzi³

et al. 2021

J Clin Monit Comput

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Abnormal coagulation parameters are often observed in patients with coronavirus disease 2019 (COVID-19) and the severity of derangement has been associated with a poor prognosis. The COVID-19 associated coagulopathy (CAC) displays unique features that include a high risk of developing thromboembolic complications. Viscoelastic tests (VETs), such as thromboelastometry (ROTEM), thromboelastography (TEG) and Quantra Hemostasis Analyzer (Quantra), provide "dynamic" data on clot formation and dissolution; they are used in different critical care settings, both in hemorrhagic and in thrombotic conditions. In patients with severe COVID-19 infection VETs can supply to clinicians more information about the CAC, identifying the presence of hypercoagulable and hypofibrinolysis states. In the last year, many studies have proposed to explain the underlying characteristics of CAC; however, there remain many unanswered questions. We tried to address some of the important queries about CAC through VETs analysis.

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Thromboelastography Profile of Patients with COVID-19 Admitted to Intensive Care Unit: A Single-center Retrospective Study from India

Cited by 9 publications

References 24 publications

Thromboelastography determined dynamics of blood coagulation and its correlation with complications and outcomes in patients with coronavirus disease 2019

Thromboelastography determined dynamics of blood coagulation and its correlation with complications and outcomes in patients with coronavirus disease 2019

Evaluation of Coagulation with TEG in Patients Diagnosed COVID-19

Questions about COVID-19 associated coagulopathy: possible answers from the viscoelastic tests

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