Thromboembolic complications in critically ill COVID-19 patients are associated with impaired fibrinolysis
BACKGROUND: There is emerging evidence for enhanced blood coagulation in coronavirus 2019 (COVID-19) patients, with thromboembolic complications contributing to morbidity and mortality. The mechanisms underlying this prothrombotic state remain enigmatic. Further data to guide anticoagulation strategies are urgently required.
METHODS: We used viscoelastic rotational thromboelastometry (ROTEM) in a single-center cohort of 40 critically ill COVID-19 patients.
RESULTS: Clear signs of a hypercoagulable state due to severe hypofibrinolysis were found. Maximum lysis, especially following stimulation of the extrinsic coagulation system, was inversely associated with an enhanced risk of thromboembolic complications. Combining values for maximum lysis with D-dimer concentrations revealed high sensitivity and specificity of thromboembolic risk prediction.
CONCLUSIONS: The study identifies a reduction in fibrinolysis as an important mechanism in COVID-19-associated coagulopathy. The combination of ROTEM and D-dimer concentrations may prove valuable in identifying patients requiring higher intensity anticoagulation.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
---|---|
Enthalten in: |
Critical care (London, England) - 24(2020), 1 vom: 07. Dez., Seite 676 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Kruse, Jan Matthias [VerfasserIn] |
---|
Links: |
---|
Themen: |
COVID-19 |
---|
Anmerkungen: |
Date Completed 31.12.2020 Date Revised 28.03.2023 published: Electronic Citation Status MEDLINE |
---|
doi: |
10.1186/s13054-020-03401-8 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM31853682X |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM31853682X | ||
003 | DE-627 | ||
005 | 20231225165544.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s13054-020-03401-8 |2 doi | |
028 | 5 | 2 | |a pubmed24n1061.xml |
035 | |a (DE-627)NLM31853682X | ||
035 | |a (NLM)33287877 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Kruse, Jan Matthias |e verfasserin |4 aut | |
245 | 1 | 0 | |a Thromboembolic complications in critically ill COVID-19 patients are associated with impaired fibrinolysis |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 31.12.2020 | ||
500 | |a Date Revised 28.03.2023 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a BACKGROUND: There is emerging evidence for enhanced blood coagulation in coronavirus 2019 (COVID-19) patients, with thromboembolic complications contributing to morbidity and mortality. The mechanisms underlying this prothrombotic state remain enigmatic. Further data to guide anticoagulation strategies are urgently required | ||
520 | |a METHODS: We used viscoelastic rotational thromboelastometry (ROTEM) in a single-center cohort of 40 critically ill COVID-19 patients | ||
520 | |a RESULTS: Clear signs of a hypercoagulable state due to severe hypofibrinolysis were found. Maximum lysis, especially following stimulation of the extrinsic coagulation system, was inversely associated with an enhanced risk of thromboembolic complications. Combining values for maximum lysis with D-dimer concentrations revealed high sensitivity and specificity of thromboembolic risk prediction | ||
520 | |a CONCLUSIONS: The study identifies a reduction in fibrinolysis as an important mechanism in COVID-19-associated coagulopathy. The combination of ROTEM and D-dimer concentrations may prove valuable in identifying patients requiring higher intensity anticoagulation | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a Coagulopathy | |
650 | 4 | |a D-dimers | |
650 | 4 | |a Hypofibrinolysis | |
650 | 4 | |a ROTEM | |
650 | 7 | |a Viscoelastic Substances |2 NLM | |
700 | 1 | |a Magomedov, Abakar |e verfasserin |4 aut | |
700 | 1 | |a Kurreck, Annika |e verfasserin |4 aut | |
700 | 1 | |a Münch, Frédéric H |e verfasserin |4 aut | |
700 | 1 | |a Koerner, Roland |e verfasserin |4 aut | |
700 | 1 | |a Kamhieh-Milz, Julian |e verfasserin |4 aut | |
700 | 1 | |a Kahl, Andreas |e verfasserin |4 aut | |
700 | 1 | |a Gotthardt, Inka |e verfasserin |4 aut | |
700 | 1 | |a Piper, Sophie K |e verfasserin |4 aut | |
700 | 1 | |a Eckardt, Kai-Uwe |e verfasserin |4 aut | |
700 | 1 | |a Dörner, Thomas |e verfasserin |4 aut | |
700 | 1 | |a Zickler, Daniel |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Critical care (London, England) |d 1997 |g 24(2020), 1 vom: 07. Dez., Seite 676 |w (DE-627)NLM097399787 |x 1466-609X |7 nnns |
773 | 1 | 8 | |g volume:24 |g year:2020 |g number:1 |g day:07 |g month:12 |g pages:676 |
856 | 4 | 0 | |u http://dx.doi.org/10.1186/s13054-020-03401-8 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 24 |j 2020 |e 1 |b 07 |c 12 |h 676 |