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Rotational Thromboelastometry (ROTEM) Profiling of COVID-19 Patients

机译：Covid-19患者的旋转血管紧节动力（Rotem）剖析

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We evaluated coagulation abnormalities via traditional tests and rotational thromboelastometry (ROTEM) in a group of 94 patients with confirmed SARS-CoV-2 infection and different severity of pneumonia (34 moderate, 25 severe, 35 critical) with the hypothesis that ROTEM parameters differed by coronavirus disease 2019 (COVID-19) severity. Shorter than normal clotting time (CT) and higher than normal maximum clot firmness (MCF) in extrinsic rotational thromboelastometry (EXTEM) and fibrinogen rotational thromboelastometry (FIBTEM), shorter than normal EXTEM clot formation time (CFT), and higher than normal alpha-angle were classified as markers of hypercoagulable state. Increment in the number of patients with >= 2 hypercoagulable parameters, higher EXTEM (P = .0001), FIBTEM MCF (P = .0001) and maximum lysis decrement (P = .002) with increment in disease severity was observed (P = .0001). Significant positive correlations between IL6 and CT EXTEM (P = .003), MCF EXTEM (P = .033), MCF FIBTEM (P = .01), and negative with ML EXTEM (P = .006) were seen. Our findings based on analysis of different disease severity groups confirmed that a hypercoagulable ROTEM pattern characterized by clot formation acceleration, high clot strength, and reduced fibrinolysis was more frequent in advanced disease groups and patients with high IL6. These results supported the need for different thromboprophylaxis approaches for different severity groups.
机译：我们通过传统检测和旋转血栓弹性测定（ROTEM）评估了94例确诊SARS-CoV-2感染和不同肺炎严重程度（34例中度、25例重度、35例危重）患者的凝血异常，假设ROTEM参数因2019年冠状病毒病（COVID-19）严重程度不同而不同。在外源性旋转血栓弹性测定法（EXTEM）和纤维蛋白原旋转血栓弹性测定法（FIBTEM）中，短于正常凝血时间（CT）和高于正常最大血栓硬度（MCF）、短于正常EXTEM血栓形成时间（CFT）和高于正常α角被归类为高凝状态的标志物。随着疾病严重程度的增加（P=0.0001），观察到高凝参数>=2、EXTEM（P=0.0001）、FIBTEM MCF（P=0.0001）和最大溶解减量（P=0.002）的患者数量增加（P=0.0001）。IL6与CT-EXTEM（P=0.003）、MCF-EXTEM（P=0.033）、MCF-FIBTEM（P=0.01）之间存在显著正相关，与ML-EXTEM（P=0.006）之间存在负相关。我们对不同疾病严重程度组的分析结果证实，在晚期疾病组和高IL6患者中，以血栓形成加速、高血栓强度和纤溶减少为特征的高凝性ROTEM模式更常见。这些结果支持了不同严重程度组需要不同的血栓预防方法。

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