Abstract
In late December 2019 an outbreak of a novel coronavirus (SARS-CoV-2) causing severe
pneumonia (COVID-19) was reported in Wuhan, Hubei Province, China. A common finding
in most COVID-19 patients is high D-dimer levels which are associated with a worse
prognosis. We aimed to evaluate coagulation abnormalities via traditional tests and
whole blood thromboelastometry profiles in a group of 22 (mean age 67 ± 8 years, M:F
20:2) consecutive patients admitted to the Intensive Care Unit of Padova University
Hospital for acute respiratory failure due to COVID-19. Cases showed significantly
higher fibrinogen and D-dimer plasma levels versus healthy controls (p < 0.0001 in both comparisons). Interestingly enough, markedly hypercoagulable thromboelastometry
profiles were observed in COVID-19 patients, as reflected by shorter Clot Formation
Time (CFT) in INTEM (p = 0.0002) and EXTEM (p = 0.01) and higher Maximum Clot Firmness (MCF) in INTEM, EXTEM and FIBTEM (p < 0.001 in all comparisons). In conclusion, COVID-19 patients with acute respiratory
failure present a severe hypercoagulability rather than consumptive coagulopathy.
Fibrin formation and polymerization may predispose to thrombosis and correlate with
a worse outcome.
Keywords
thromboelastometry - fibrinogen/fibrin - thrombotic complications
