Hypofibrinolytic state and high thrombin generation may play a major role in SARS-COV2 associated thrombosis.
J Thromb Haemost
; 18(9): 2215-2219, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-645249
ABSTRACT
BACKGROUND:
Thirty percent of Covid-19 patients admitted to intensive care units present with thrombotic complications despite thromboprophylaxis. Bed rest, obesity, hypoxia, coagulopathy, and acute excessive inflammation are potential mechanisms reported by previous studies. Better understanding of the underlying mechanisms leading to thrombosis is crucial for developing more appropriate prophylaxis and treatment strategies.OBJECTIVE:
We aimed to assess fibrinolytic activity and thrombin generation in 78 Covid-19 patients. PATIENTS ANDMETHODS:
Forty-eight patients admitted to the intensive care unit and 30 patients admitted to the internal medicine department were included in the study. All patients received thromboprophylaxis. We measured fibrinolytic parameters (tissue plasminogen activator, PAI-1, thrombin activatable fibrinolysis inhibitor, alpha2 anti-plasmin, and tissue plasminogen activator-modified ROTEM device), thrombin generation, and other coagulation tests (D-dimer, fibrinogen, factor VIII, antithrombin). RESULTS ANDCONCLUSIONS:
We observed two keyfindings:
a high thrombin generation capacity that remained within normal values despite heparin therapy and a hypofibrinolysis mainly associated with increased PAI-1 levels. A modified ROTEM is able to detect both hypercoagulability and hypofibrinolysis simultaneously in Covid-19 patients with thrombosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thrombosis
/
Thrombin
/
Fibrinolysis
/
COVID-19
Type of study:
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Thromb Haemost
Journal subject:
Hematology
Year:
2020
Document Type:
Article
Affiliation country:
Jth.15016
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