tetano
Editor, Senior Moderator
Adv Med Sci
. 2021 Dec 11;67(1):39-44.
doi: 10.1016/j.advms.2021.12.001. Online ahead of print.
Cardiac injury and COVID-19 associated coagulopathy in patients with acute SARS-CoV-2 pneumonia: A rotational thromboelastometry study
Federico Capone[SUP] 1 [/SUP], Alberto Cipriani[SUP] 2 [/SUP], Leonardo Molinari[SUP] 1 [/SUP], Anna Poretto[SUP] 1 [/SUP], Nicolò Sella[SUP] 3 [/SUP], Annalisa Boscolo[SUP] 3 [/SUP], Elena Campello[SUP] 1 [/SUP], Alois Saller[SUP] 1 [/SUP], Roberto Vettor[SUP] 1 [/SUP], Paolo Navalesi[SUP] 3 [/SUP], Anna Maria Cattelan[SUP] 4 [/SUP], Paolo Simioni[SUP] 5 [/SUP], Luca Spiezia[SUP] 6 [/SUP]
Affiliations
Abstract
Purpose: Coronavirus disease 2019 (COVID-19) is a systemic inflammatory condition associated with coagulopathy which may result in severe thromboembolic complications. Cardiac injury is not uncommon in hospitalized COVID-19 patients and therefore we aimed to investigate whether it stems from an abnormal coagulative state.
Materials and methods: We conducted a retrospective cross-sectional study on consecutive patients hospitalized due to COVID-19. Traditional coagulation and whole blood rotational thromboelastometry tests were compared between patients with and without cardiac injury. Cardiac injury was defined by increased levels of high-sensitivity cardiac troponin I (hs-cTnI).
Results: The study population consisted of 104 patients (67% males, median age 65 years), of whom 40 (38%) developed cardiac injury. No clinical differences in the traditional coagulation parameters were observed between patients with and without cardiac injury. Thromboelastometry analysis revealed abnormal maximum clot firmness (MCF) levels in FIBTEM assay in 80 (77%) patients. No significant differences in MCF values (p = 0.450) and percentage of abnormal MCF (p = 0.290) were detected between patients with and without cardiac injury. Cardiac injury - not hypercoagulability - was associated with mortality (p = 0.016).
Conclusions: No differences in traditional coagulation and rotational thromboelastometry parameters were found among hospitalized COVID-19 patients with and without cardiac injury. Other mechanisms besides hypercoagulability may be a main culprit for cardiac injury in COVID-19 patients.
Keywords: COVID-19; Coronary thrombosis; Hypercoagulability; Rotational thromboelastometry; Troponin.
. 2021 Dec 11;67(1):39-44.
doi: 10.1016/j.advms.2021.12.001. Online ahead of print.
Cardiac injury and COVID-19 associated coagulopathy in patients with acute SARS-CoV-2 pneumonia: A rotational thromboelastometry study
Federico Capone[SUP] 1 [/SUP], Alberto Cipriani[SUP] 2 [/SUP], Leonardo Molinari[SUP] 1 [/SUP], Anna Poretto[SUP] 1 [/SUP], Nicolò Sella[SUP] 3 [/SUP], Annalisa Boscolo[SUP] 3 [/SUP], Elena Campello[SUP] 1 [/SUP], Alois Saller[SUP] 1 [/SUP], Roberto Vettor[SUP] 1 [/SUP], Paolo Navalesi[SUP] 3 [/SUP], Anna Maria Cattelan[SUP] 4 [/SUP], Paolo Simioni[SUP] 5 [/SUP], Luca Spiezia[SUP] 6 [/SUP]
Affiliations
- PMID: 34906908
- DOI: 10.1016/j.advms.2021.12.001
Abstract
Purpose: Coronavirus disease 2019 (COVID-19) is a systemic inflammatory condition associated with coagulopathy which may result in severe thromboembolic complications. Cardiac injury is not uncommon in hospitalized COVID-19 patients and therefore we aimed to investigate whether it stems from an abnormal coagulative state.
Materials and methods: We conducted a retrospective cross-sectional study on consecutive patients hospitalized due to COVID-19. Traditional coagulation and whole blood rotational thromboelastometry tests were compared between patients with and without cardiac injury. Cardiac injury was defined by increased levels of high-sensitivity cardiac troponin I (hs-cTnI).
Results: The study population consisted of 104 patients (67% males, median age 65 years), of whom 40 (38%) developed cardiac injury. No clinical differences in the traditional coagulation parameters were observed between patients with and without cardiac injury. Thromboelastometry analysis revealed abnormal maximum clot firmness (MCF) levels in FIBTEM assay in 80 (77%) patients. No significant differences in MCF values (p = 0.450) and percentage of abnormal MCF (p = 0.290) were detected between patients with and without cardiac injury. Cardiac injury - not hypercoagulability - was associated with mortality (p = 0.016).
Conclusions: No differences in traditional coagulation and rotational thromboelastometry parameters were found among hospitalized COVID-19 patients with and without cardiac injury. Other mechanisms besides hypercoagulability may be a main culprit for cardiac injury in COVID-19 patients.
Keywords: COVID-19; Coronary thrombosis; Hypercoagulability; Rotational thromboelastometry; Troponin.