Complex and prolonged hypercoagulability in coronavirus disease 2019 intensive care unit patients: A thromboelastographic study.
Pierre-Yves Cordier, Candice Pierrou, Alexandre Noel and 10 others
PMID 33509706WHAT IT FOUND
In 24 ICU patients with COVID-19, clot tests showed faster, stronger clot formation than in 20 healthy people.
In 10 retested before discharge, clot strength did not normalise, despite no proven link to thrombotic events.
Key findings
01Five patients had pulmonary embolism and two had ischaemic stroke.
02Compared with 20 healthy controls, 24 ICU patients had faster clot initiation and stronger clots on whole-blood testing.
03In 10 patients retested before ICU discharge, the coagulation index was 2.3 at admission and 2.4 at discharge; maximum amplitude rose from 72 mm to 77 mm and clot strength from 13.1 to 17.0 dyn/cm2.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was small, single-centre and retrospective, with 24 patients and 20 healthy controls. 2 patients were excluded because they were taking oral anticoagulants at admission, so the findings do not apply to that group. The control group had a median age of 38 years, while patients had a median age of 69 years, so differences may not be due to COVID-19 alone. Thrombotic events were investigated only when clinically indicated, not systematically for the study, so their occurrence may have been underestimated. The study did not find a significant difference in TEG parameters between patients with and without thrombotic complications, so it cannot show that these tests identify patients who will clot.
Declared interests
No specific funding grant was received, and the authors declared no conflict of interest.
The easy way to misread this
Do not read the hypercoagulable clot profile as proof that thromboelastography can predict thrombotic events or guide anticoagulation. The study did not show a significant difference in TEG parameters between patients with and without thrombotic complications, and complications were only investigated when clinically needed.