COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other respiratory viral (non-CoV-2-RV) infections are associated with thrombotic complications. The differences in prothrombotic potential between SARS-CoV-2 and non-CoV-2-RV have not been well characterised. We compared the thrombotic rates between these two groups of patients directly and further delved into their coagulation profiles. In this single-center, retrospective cohort study, all consecutive COVID-19 and non-CoV-2-RV patients admitted between January 15th and April 10th 2020 were included. Coagulation parameters studied were prothrombin time and activated partial thromboplastin time and its associated clot waveform analysis (CWA) parameter, min1, min2 and max2. In the COVID-19 (n = 181) group there were two (1.0 event/1000-hospital-days) myocardial infarction events while one (1.8 event/1000-hospital-day) was reported in the non-CoV-2-RV (n = 165) group. These events occurred in patients who were severely ill. There were no venous thrombotic events. Coagulation parameters did not differ throughout the course of mild COVID-19. However, CWA parameters were significantly higher in severe COVID-19 compared with mild disease, suggesting hypercoagulability (min1: 6.48%/s vs 5.05%/s, P < 0.001; min2: 0.92%/s 2 vs 0.74%/s 2 , P = 0.033). In conclusion, the thrombotic rates were low and did not differ between COVID-19 and non-CoV-2-RV patients. The hypercoagulability in COVID-19 is a highly dynamic process with the highest risk occurring when patients were most severely ill. Such changes in haemostasis could be detected by CWA. In our population, a more individualized thromboprophylaxis approach, considering clinical and laboratory factors, is preferred over universal pharmacological thromboprophylaxis for all hospitalized COVID-19 patients and such personalized approach warrants further research.
【저자키워드】 viral infection, Biomarkers, Infectious diseases, Epidemiology, 【초록키워드】 COVID-19, SARS-CoV-2, severe COVID-19, Thrombotic complications, Infection, risk, severe acute respiratory syndrome coronavirus-2, severe acute respiratory syndrome Coronavirus, Laboratory, Coagulation, Severe acute respiratory syndrome, Viral, Research, Patient, Factors, Mild, haemostasis, Myocardial infarction, respiratory, Thrombotic events, patients, hypercoagulability, Mild disease, hospitalized COVID-19 patient, Thromboprophylaxis, Analysis, Prothrombin time, partial thromboplastin time, retrospective cohort study, activated partial thromboplastin time, profiles, thrombotic, single-center, Coagulation parameters, parameter, pharmacological, approach, event, venous, respiratory viral, prothrombotic, Course, highest, not differ, occurred, caused, reported, activated, changes in, significantly higher, two group, with mild disease, 【제목키워드】 COVID-19, Comorbidity, Viral, clinical, respiratory, respiratory viral infection, laboratory feature,