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Review
. 2022 Feb;36(1):55-69.
doi: 10.1007/s10877-021-00744-7. Epub 2021 Jul 15.

Questions about COVID-19 associated coagulopathy: possible answers from the viscoelastic tests

Vittorio Pavoni  1 , Lara Gianesello  2 , Maddalena Pazzi  1 , Pietro Dattolo  3 , Domenico Prisco  4
Affiliations
Review

Questions about COVID-19 associated coagulopathy: possible answers from the viscoelastic tests

Vittorio Pavoni et al. J Clin Monit Comput. 2022 Feb.

Abstract

Abnormal coagulation parameters are often observed in patients with coronavirus disease 2019 (COVID-19) and the severity of derangement has been associated with a poor prognosis. The COVID-19 associated coagulopathy (CAC) displays unique features that include a high risk of developing thromboembolic complications. Viscoelastic tests (VETs), such as thromboelastometry (ROTEM), thromboelastography (TEG) and Quantra Hemostasis Analyzer (Quantra), provide "dynamic" data on clot formation and dissolution; they are used in different critical care settings, both in hemorrhagic and in thrombotic conditions. In patients with severe COVID-19 infection VETs can supply to clinicians more information about the CAC, identifying the presence of hypercoagulable and hypofibrinolysis states. In the last year, many studies have proposed to explain the underlying characteristics of CAC; however, there remain many unanswered questions. We tried to address some of the important queries about CAC through VETs analysis.

Keywords: COVID-19; Coagulopathy; Thromboembolic events; Viscoelastic tests.

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Conflict of interest statement

The authors declare that they have no conflicts of interest related to the present work.

Figures

Fig. 1
Fig. 1
TEG and ROTEM parameters and their significance. *TEG and ROTEM fibrinolysis parameters refer to different starting points. Whereas, ROTEM LI30, LI45 and LI60 are measured 30, 45 and 60 min after CT, TEG LY30 is measured 30 min after MA. Since TEG time to MA is about 30 min, LY30 is measured after about 60 min runtime as LI60 in ROTEM. In order to detect fibrinolysis shutdown, a runtime of 60 min (TEG LY30 or ROTEM LI60) is needed
Fig. 2
Fig. 2
Quantra parameters and their significance
See this image and copyright information in PMC

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