Salem Nouran, Atallah Bassam, El Nekidy Wasim S, Sadik Ziad G, Park Woosup Michael, Mallat Jihad
Department of Pharmacy, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
J Thromb Thrombolysis. 2021 May;51(4):961-965. doi: 10.1007/s11239-020-02300-7. Epub 2020 Oct 4.
The rate of venous and arterial thrombotic events among patients infected with severe acute respiratory syndrome coronavirus-2 (SAR-CoV-2) is high. This may be due to a hypercoagulable state induced by the severe inflammation that results from the SAR-CoV-2 infection. We aimed to determine hypercoagulable states' incidence based on thromboelastography study and its association with thrombotic events in critically ill patients with coronavirus disease 2019 (COVID-19). Fifty-two COVID-19 patients who had thromboelastography study were retrospectively included. All patients received pharmacologic thromboprophylaxis. The hypercoagulable state was observed in 16 patients (30.8%). Among them, maximum amplitude and a-angle were elevated in 75% and 25%, respectively. Reaction time and K were low in only 12.5% for both of them. Inflammatory and coagulation markers, as well as thromboprophylaxis regimens, were not associated with a hypercoagulable state. Fourteen patients (27%) experienced a total of 16 thrombotic events, including 8 (57%) deep venous thrombosis, 6 (43%) pulmonary embolism, and 2 (14.3%) arterial thrombosis. The hypercoagulable state was not significantly associated with thrombotic events. In summary, we observed a lower rate of hypercoagulable state on thromboelastography study in critically ill COVID-19 patients. Also, the hypercoagulable state was not associated with the occurrence of thrombotic events.
感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者中静脉和动脉血栓形成事件的发生率很高。这可能是由于SARS-CoV-2感染引起的严重炎症导致的高凝状态。我们旨在根据血栓弹力图研究确定高凝状态的发生率及其与2019冠状病毒病（COVID-19）重症患者血栓形成事件的关联。回顾性纳入了52例接受血栓弹力图研究的COVID-19患者。所有患者均接受了药物性血栓预防。16例患者（30.8%）观察到高凝状态。其中，最大振幅和a角升高的分别占75%和25%。反应时间和K值两者均仅在12.5%的患者中较低。炎症和凝血标志物以及血栓预防方案与高凝状态无关。14例患者（27%）共发生16次血栓形成事件，包括8例（57%）深静脉血栓形成、6例（43%）肺栓塞和2例（14.3%）动脉血栓形成。高凝状态与血栓形成事件无显著关联。总之，我们在COVID-19重症患者的血栓弹力图研究中观察到高凝状态的发生率较低。此外，高凝状态与血栓形成事件的发生无关。
