Abstract Number: PB0206
Meeting: ISTH 2021 Congress
Background: Hospitalized COVID-19 patients often show a hypercoagulable profile, mainly elevated fibrinogen and D-dimer, associated with worse outcomes in terms of ICU admission, thrombotic events and mortality. Increased clot stiffness on whole blood viscoelastic testing (VET) is another hypercoagulable profile observed in COVID-19 patients. Sonic Estimation of Elasticity by Resonance (SEER) sonorheometry (Quantra® system) is a novel ultrasound based VET technology.
Aims: To characterize the hemostatic status of COVID-19 patients with standard and viscoelastic testings and its association with disease severity.
Methods: Blood samples from adult COVID-19 patients at hospital admission were analyzed with a panel of tests including markers of inflammation, coagulation and Quantra VET parameters. Fisher’s exact test was used to statistically compare the moderate and severe/critical disease groups.
Results: The cohort of 37 patients showed a mean age (SD) of 59.6 (16) years, with 23 of them in the moderate disease group and 14 in the severe/critical disease group. Markers of inflammation were elevated in 44-84% of patients, while of coagulation tests, only fibrinogen (79%) and D-dimer (60%) levels were elevated. Clot stiffness (CS), as well as the contribution of platelets (PCS) and fibrinogen (FCS) measured by Quantra, were also above normal values at 64.3, 50 and 78.6%, respectively. These parameters were the only ones significantly associated with the severe/critical disease group (Table 1), where most of the adverse outcome were observed. According to this result, the median of these parameters was significantly different between the two groups (p=0.011/0.029/0.008).
|Test||ULN||All (%)||Moderate (%)||Severe/
|Platelet count (x 103/µL)||450||1/37 (2.7)||0/23 (0.0)||1/14 (7.1)||0.378|
|Fibrinogen (mg/dL)||400||27/34 (79.4)||14/20 (70.0)||13/14 (92.9)||0.198|
|D-dimer (µg/L)||500||22/37 (59.5)||12/23 (52.2)||10/14 (71.4)||0.314|
|CT (sec)||164||1/37 (2.7)||1/23 (4.3)||0/14 (0.0)||1.000|
|CSL (%)||99||8/26 (30.8)||2/13 (15.4)||6/13 (46.2)||0.202|
|CS (hPa)||33.2||12/37 (32.4)||3/23 (13.0)||9/14 (64.3)||0.003|
|PCS (hPa)||29.8||9/36 (25.0)||2/22 (9.1)||7/14 (50.0)||0.014|
|FCS (hPa)||3.7||21/37 (56.8)||10/23 (43.5)||11/14 (78.6)||0.048|
Conclusions: The study of global hemostatic status using Quantra can be a powerful tool for the analysis of COVID-19 patients at admission, helping in risk stratification and triage decisions of patients. This profile, characterized by increased clot stiffness from both platelet and fibrinogen contribution, was most prevalent in patients with severe/critical disease, and could therefore be established as a new prognostic marker.
To cite this abstract in AMA style:López Jaime FJ, Martín-Téllez S, Doblas-Márquez A, Márquez-Gómez I, Alemany J, Pérez-Raya M, Mena-Santano AM, Muñoz-López DF, Muñoz-Pérez MI, Fernández-Bello I, Montaño A. Hypercoagulability Detected by Seer Sonorheometry in Covid-19 Patients at Hospital Admission [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/hypercoagulability-detected-by-seer-sonorheometry-in-covid-19-patients-at-hospital-admission/. Accessed November 27, 2021.
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