Background Coronavirus disease 2019 (COVID-19) associated coagulopathy (CAC) leads to thromboembolic events in a high number of critically ill COVID-19 patients. However, specific diagnostic or therapeutic algorithms for CAC have not been established. In the current study, we analyzed coagulation abnormalities with point-of-care testing (POCT) and their relation to hemostatic complications in patients suffering from COVID-19 induced Acute Respiratory Distress Syndrome (ARDS). Our hypothesis was that specific diagnostic patterns can be identified in patients with COVID-19 induced ARDS at risk of thromboembolic complications utilizing POCT. Methods This is a single-center, retrospective observational study. Longitudinal data from 247 rotational thromboelastometries (Rotem®) and 165 impedance aggregometries (Multiplate®) were analysed in 18 patients consecutively admitted to the ICU with a COVID-19 induced ARDS between March 12th to June 30th, 2020. Results Median age was 61 years (IQR: 51–69). Median PaO 2 /FiO 2 on admission was 122 mmHg (IQR: 87–189), indicating moderate to severe ARDS. Any form of hemostatic complication occurred in 78 % of the patients with deep vein/arm thrombosis in 39 %, pulmonary embolism in 22 %, and major bleeding in 17 %. In Rotem® elevated A10 and maximum clot firmness (MCF) indicated higher clot strength. The delta between EXTEM A10 minus FIBTEM A10 (ΔA10) > 30 mm, depicting the sole platelet-part of clot firmness, was associated with a higher risk of thromboembolic events (OD: 3.7; 95 %CI 1.3–10.3; p = 0.02). Multiplate® aggregometry showed hypoactive platelet function. There was no correlation between single Rotem® and Multiplate® parameters at intensive care unit (ICU) admission and thromboembolic or bleeding complications. Conclusions Rotem® and Multiplate® results indicate hypercoagulability and hypoactive platelet dysfunction in COVID-19 induced ARDS but were all in all poorly related to hemostatic complications..
【저자키워드】 COVID-19, acute respiratory distress syndrome, point of care testing, Thromboelastometry, Impedance aggregometry, 【초록키워드】 Coronavirus disease 2019, ARDS, thrombosis, intensive care, diagnostic, risk, ICU, Coagulation, Coagulopathy, point-of-care, Critically ill, Algorithm, therapeutic, Patient, POCT, bleeding, Platelet, Complication, complications, age, respiratory, longitudinal, Admission, moderate, hypercoagulability, COVID-19 patients, retrospective, Hypothesis, dysfunction, thromboembolic, higher risk, severe ARDS, single-center, no correlation, abnormality, major bleeding, parameter, Thromboembolic event, Result, analyzed, occurred, indicated, the patient, elevated, analysed, PaO, patients with COVID-19, thromboembolic complication, 【제목키워드】 diagnostic, Platelet, Care, hypercoagulability, acute respiratory distress, retrospective, Point,