Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Lize M. Grobbelaar; Arneaux Kruger; Chantelle Venter; Este M. Burger; Gert J. Laubscher; Tongai G. Maponga; Maritha J. Kotze; Hau C. Kwaan; Joseph B. Miller; Daniel Fulkerson; Wei Huff; Eric Chang; Grant Wiarda; Connor M. Bunch; Mark M. Walsh; Syed Raza; Mahmud Zamlut; Hunter B. Moore; Ernest E. Moore; Matthew D. Neal; Douglas B. Kell; Etheresia Pretorius

doi:10.1055/s-0042-1756306

Seminars in Thrombosis and Hemostasis, Inhaltsverzeichnis

Semin Thromb Hemost 2022; 48(07): 858-868
DOI: 10.1055/s-0042-1756306

Review Article

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Lize M. Grobbelaar

¹Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Matieland, South Africa

,

Arneaux Kruger

¹Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Matieland, South Africa

,

Chantelle Venter

¹Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Matieland, South Africa

,

Este M. Burger

²BioCODE Technologies, Stellenbosch, South Africa

,

Gert J. Laubscher

³Mediclinic Stellenbosch, Stellenbosch, South Africa

,

Tongai G. Maponga

⁴Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

,

Maritha J. Kotze

⁵Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa

,

Hau C. Kwaan

⁶Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

,

Joseph B. Miller

⁷Departments of Emergency Medicine and Internal Medicine, Henry Ford Hospital, Detroit, Michigan

,

Daniel Fulkerson

⁸Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, Indiana

,

Wei Huff

⁸Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, Indiana

,

Eric Chang

⁹Indiana University School of Medicine - South Bend, Notre Dame, Indiana

,

Grant Wiarda

¹⁰Department of Internal Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Connor M. Bunch

⁷Departments of Emergency Medicine and Internal Medicine, Henry Ford Hospital, Detroit, Michigan

,

Mark M. Walsh

⁹Indiana University School of Medicine - South Bend, Notre Dame, Indiana

¹⁰Department of Internal Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

¹¹Department of Emergency Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Syed Raza

¹²Department of Critical Care Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Mahmud Zamlut

¹²Department of Critical Care Medicine, Saint Joseph Regional Medical Center, Mishawaka, Indiana

,

Hunter B. Moore

¹³Division of Transplant Surgery, Department of Surgery, Denver Health and University of Colorado Health Sciences Center, Denver, Colorado

,

Ernest E. Moore

¹⁴Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health and University of Colorado Health Sciences Center, Denver, Colorado

,

Matthew D. Neal

¹⁵Pittsburgh Trauma Research Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

,

Douglas B. Kell

¹Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Matieland, South Africa

¹⁶Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, England, United Kingdom

¹⁷The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Lyngby, Denmark

,

Etheresia Pretorius

¹Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Matieland, South Africa

¹⁷The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Lyngby, Denmark

› Institutsangaben

Abstract

Earlier variants of SARS-CoV-2 have been associated with hypercoagulability and an extensive formation of fibrin amyloid microclots, which are considered to contribute to the pathology of the coronavirus 2019 disease (COVID-19). The newer omicron variants appear to be far more transmissible, but less virulent, even when taking immunity acquired from previous infections or vaccination into account. We here show that while the clotting parameters associated with omicron variants are significantly raised over those of healthy, matched controls, they are raised to levels significantly lower than those seen with more severe variants such as beta and delta. We also observed that individuals infected with omicron variants manifested less extensive microclot formation in platelet-poor plasma compared with those harboring the more virulent variants. The measurement of clotting effects between the different variants acts as a kind of “internal control” that demonstrates the relationship between the extent of coagulopathies and the virulence of the variant of interest. This adds to the evidence that microclots may play an important role in reflecting the severity of symptoms observed in COVID-19.

Keywords

COVID-19 - variants - Omicron - coagulation - fluorescence microscopy - microclots

Volltext

Referenzen

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