1
|
Tsantes AE, Frantzeskaki F, Tsantes AG, Rapti E, Rizos M, Kokoris SI, Paramythiotou E, Katsadiotis G, Karali V, Flevari A, Chrysanthopoulou E, Maratou E, Kyriakou E, Gialeraki A, Bonovas S, Dimopoulos G, Tsangaris I, Armaganidis A. The haemostatic profile in critically ill COVID-19 patients receiving therapeutic anticoagulant therapy: An observational study. Medicine (Baltimore) 2020; 99:e23365. [PMID: 33217881 PMCID: PMC7676559 DOI: 10.1097/md.0000000000023365] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Hypercoagulability and thrombosis remain a challenge in severe coronavirus disease 2019 (COVID-19) infections. Our aim is to investigate the hemostatic profile of critically ill COVID-19 patients on therapeutic anticoagulant treatment.Forty one patients were enrolled into the study. We recruited 11 consecutive, COVID-19, patients who received therapeutic anticoagulant treatment on intensive care unit (ICU) admission. Disease severity indexes, biochemical, hematological and haemostatic parameters, endogenous thrombin potential (ETP), plasminogen activator inhibitor-1 (PAI-1) activity and extrinsically activated rotational thromboelastometry assay (EXTEM) were recorded on days 1, 3, 7. We also enrolled 9 ICU non-COVID-19, 21 non-ICU COVID-19 patients and 20 healthy blood donors as control populations.Critically ill COVID-19 patients demonstrated a more hypercoagulable and hypofibrinolytic profile related to those with COVID-19 mild illness, based on EXTEM amplitude at 10 min (A10), maximum clot firmness (MCF) and lysis index at 60 min (LI60) variables (p = 0.020, 0.046 and 0.001, respectively). Similarly, a more hypercoagulable state was detected in COVID-19 ICU patients related to non-COVID-19 ICU patients based on A10 and MCF parameters (p = 0.03 and 0.04, respectively). On the contrary, ETP and EXTEM (clotting time) CT values were similar between patients with severe and mild form of the COVID-19 infection, probably due to anticoagulant treatment given.Critically ill COVID-19 patients showed a hypercoagulable profile despite the therapeutic anticoagulant doses given. Due to the small sample size and the study design, the prognostic role of the hypercoagulability in this clinical setting remains unknown and further research is required in order to be assessed.
Collapse
Affiliation(s)
- Argirios E. Tsantes
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Frantzeska Frantzeskaki
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Andreas G. Tsantes
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Evdoxia Rapti
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Michalis Rizos
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Styliani I. Kokoris
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Elizabeth Paramythiotou
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Georgios Katsadiotis
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | | | - Aikaterini Flevari
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Evangelia Chrysanthopoulou
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Eirini Maratou
- Laboratory of Clinical Biochemistry, “Attikon” University Hospital, Medical School, University of Athens, Athens, Greece
| | - Elias Kyriakou
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Argyri Gialeraki
- Laboratory of Hematology and Blood Bank Unit, “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University
- Humanitas Clinical and Research Center, – IRCCS, Milan, Italy
| | - George Dimopoulos
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Iraklis Tsangaris
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| | - Apostolos Armaganidis
- Second Department of Critical Care, “Attikon” University Hospital, National and Kapodistrian University of Athens, Medical School
| |
Collapse
|