Evaluation of coagulation function in critically ill patients with severe Covid-19 pneumonia

ABSTRACT

Background-aim: In addition to typical respiratory symptoms, COVID-19 is associated with coagulation abnormalities that lead to thromboembolic complications. Methods: Retrospective study of critically ill patients admitted to an intensive care unit (ICU) a cause of severe COVID-19 pneumonia (Group 1) and we evaluated coagulation function using coagulation standard parameters on day of admission (T0) and 10 (T10) days after admission to ICU and rotational thromboelastometry (ClotPro). In addition, we compared coagulation standard parameters to patients with severe non–COVID-19 pneumonia (Group 2). Results: Eighty-four patients participated in our study. Traditional coagulation parameters were similar between group 1 and group 2. Only D-dimer levels (2442.11 ng / ml vs 370 ng / ml, p = 0.03) were significantly higher in COVID-19 pneumonia than in non-COVID-19 pneumonia. In addition, we concluded an increase in D-dimer levels during the hospital stay (T0 = 2442.11 ng / ml vs T10 = 8564.39 ng / ml, p = 0.000). Finally, patients with SARS-CoV-2 pneumonia exhibited hypercoagulant thromboelatometry profiles, characterized by elevated maximum clot firmness (MCF) values. Conclusions: The results observed in our study support hypercoagulability in a severe inflammatory state, rather than a disseminated intravascular coagulation (DIC). More studies are needed to allow a better understanding of the coagulopathy produced in patients with severe COVID-19 pneumonia.