Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Coagulation Profile Monitoring of COVID-19 Patients with Standard and Viscoelastic Point of Care Hemostasis Tests

Version 1 : Received: 3 June 2023 / Approved: 5 June 2023 / Online: 5 June 2023 (08:15:17 CEST)

A peer-reviewed article of this Preprint also exists.

Milić, D.; Lazarević, M.; Vuković, N.; Kamenov, A.; Perić, V.; Golubović, M.; Stošić, M.; Spasić, D.; Stojiljković, V.; Stokanović, D. Monitoring the Coagulation Profile of COVID-19 Patients Using Standard and ClotPro® Hemostasis Tests. Medicina 2023, 59, 1202. Milić, D.; Lazarević, M.; Vuković, N.; Kamenov, A.; Perić, V.; Golubović, M.; Stošić, M.; Spasić, D.; Stojiljković, V.; Stokanović, D. Monitoring the Coagulation Profile of COVID-19 Patients Using Standard and ClotPro® Hemostasis Tests. Medicina 2023, 59, 1202.

Abstract

Background and Objectives: Coagulation disorders during COVID-19 infection are associated with poor prognosis and disease severity, because two processes that interfere each other are thrombosis and inflammation. Very important issue for clinicians is timely and adequate hemostasis and inflammation monitoring in order to prevent and treat potentially lethal consequences. Materials and Methods: The study was approved by the Ethics Committee of the Clinical center Nis, Serbia. One hundered fourty two patients presented with COVID-19 ARDS were admitted to the ICU in Clinic for anesthesiology Clinical Center Nis, from 14th April 2020 to 25 th May 2020. On admission blood was collected for biochemical and coagulation testing. The data obtained was analyzed using Statistical Package for Social Sciences (SPSS v. 25, Chicago, IL, USA). Results: Among all parameters assessed, mortality was associated with higher age (p<0.05), higher factor I (p<0.05), INR (p<0.001), D-Dimer (p<0.001), ADP (p<0.001), ASPI (p<0.001), TRAP (p<0.001), PSEP (p<0.001), A5 extest (p<0.01), A10 ex test (p<0.01), A5 fib (p<0.001), A10fib (p<0.001) and MCF fib (p<0.001) values, but lower CT extest values (p<0.05). Mortality was associated with extreme values of D-Dimer above 1000 (p<0.001), ADP above 590 (p<0.001), ASPI above 800 (p<0.001), TRAP above 1500 (p<0.001) and PSEP above 1000 (p<0.05). Conclusions: The key to success in the treatment of COVID 19 infection is timely and adequate therapy and patient monitoring, which is impossible without early risk stratification and mortality prediction. Sophisticated hemostasis parameters can contribute to early risk assessment, which was initially performed only on the basis of the patient's clinical status.

Keywords

COVID 19; coagulation; viscoelastic tests; thrombosis; mortality

Subject

Medicine and Pharmacology, Clinical Medicine

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