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Hemostasiological Blood Properties in Patients with COVID-19 Associated Viral Pneumonia

M. Presnyakova1, E. Galova1, O. Kostina1

1Federal State Budgetary Educational Institution of Higher Education ‘Privolzhsky Research Medical University‘ of the Ministry of Health of the Russian Federation, Nizny Novgorod, Russian Federation

Abstract Number: PB0162

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Basic Science

Background: Impaired hemostasis is one of the main elements of COVID-19 associated pneumonia pathogenesis. Early detection and adequate correction of hemostasis impairments determine the pneumonia course and outcome.

Aims: The investigation objective was to study the changes of standard hemostasiological tests and thromboelastography indices in COVID-19 associated pneumonia patients.

Methods: We determined APTT, prothrombin time (PT), fibrinogen (F), D-dimers (D-d), antitrombin III (AT III), С-reactive protein (CRP), platelet count, and studied viscosity and elasticity of blood clots using kaolin-activated thromboelastography (TEG) in 49 patients aged 40-69 with clinical presentation of viral infection and bilateral multi-segmental pneumonia. According to CT, the severity of 100% cases corresponded to CT2-CT3. Acute respiratory failure (ARF) was diagnosed in 16 patients. A control group included 25 apparently healthy subjects.

Results: There were revealed a marked acute-phase reaction characterized by increased fibrinogen (5.44 [4.34; 7.0]) and CRP (34.5 [16.0; 108]) concentrations, high D-d concentration (819 [472; 1769]) indicating intravascular homeostasis activation, and PT prolongation, which are descriptive of protein synthesis hepatic function (12.8 [12.5; 13.5]). D-d concentration correlated with patient`s age (r=0.61; p<0.05) and comorbidity (r=0.58; p<0.05). We found neither the alterations in TEG findings, nor the association between TEG parameters characterizing blood clot density (МА and G) and a fibrinogen level; yet there was revealed the relationship of the characteristics and platelet count (r=0.61; p<0.05).

Conclusions: Patients with COVID-19 associated pneumonia present impaired hemostatic system of thrombogenic nature. Moreover, kaolin-activated thromboelastography appeared to be less informative, so further investigations are required to make an objective assessment of blood viscosity and elasticity.

To cite this abstract in AMA style:

Presnyakova M, Galova E, Kostina O. Hemostasiological Blood Properties in Patients with COVID-19 Associated Viral Pneumonia [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/hemostasiological-blood-properties-in-patients-with-covid-19-associated-viral-pneumonia/. Accessed September 30, 2023.

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