Background Severe disease due to the novel coronavirus disease 2019 (COVID-19) has been shown to be associated with hypercoagulation. The aim of this study was to assess the Rotational Thromboelastometry (ROTEM) as a marker of coagulopathy in hospitalized COVID-19 patients. Methods This was a prospective, observational study where patients hospitalized due to a COVID-19 infection were eligible for inclusion. Conventional coagulation tests and ROTEM were taken after hospital admission, and patients were followed for 30 days. A prediction model, including variables ROTEM EXTEM-MCF (Maximum Clot Firmness) which in previous data has been suggested a suitable marker of hypercoagulation, age, and respiratory frequency, was developed using logistic regression to evaluate the probability of death. Results Out of the 141 patients included, 18 (13%) died within 30 days. In the final prediction model, the risk of death within 30 days for a patient hospitalized due to COVID-19 was increased with increased EXTEM-MCF, age, and respiratory frequency. Longitudinal ROTEM data in the severely ill subpopulation showed enhanced hypercoagulation. In an in vitro analysis, no heparin effect on EXTEM–coagulation time (CT) was observed, supporting a severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) effect on prolonged initiation of coagulation. Conclusion Here, we show that hypercoagulation measured with ROTEM predicts 30-day mortality in COVID-19. Longitudinal ROTEM data strengthen the hypothesis of hypercoagulation as a driver of severe disease in COVID-19. Thus, ROTEM may be a useful tool to assess disease severity in COVID-19 and could potentially guide anticoagulation therapy.
【저자키워드】 COVID-19, Mortality, thrombosis, Coagulopathy, Thromboelastometry, 【초록키워드】 SARS-CoV-2, therapy, Hospitalized, anticoagulation, disease severity, in vitro, novel coronavirus disease, Coagulation, Probability, COVID-19 infection, Patient, death, Logistic regression, age, Hospital admission, longitudinal, disease, predict, 30-Day mortality, marker, Hypothesis, Analysis, severe disease, coagulation test, risk of death, hospitalized COVID-19 patients, maximum, Final, subpopulation, clot, variable, Result, shown, evaluate, died, suggested, Conventional, eligible, for inclusion, patients hospitalized, respiratory frequency, was increased, 【제목키워드】 Prospective, Model, Hypercoagulation,