Association between thrombin generation and clinical characteristics in COVID-19 patients

Introduction: COVID-19 disease is associated with coagulopathy and increased risk of thrombosis. An association between thrombin generation (TG) capacity, disease severity and outcomes has not been well described.Methods: We assessed the correlation of TG with sequential organ failure assessment (SOFA) and sepsis-induced coagulopathy (SIC) scores and clinical outcomes by analysis of plasma samples obtained from hospitalized COVID-19 patients.Results: 32 patients (68.8% male), whose median age was 69 years were assessed, of whom only 3 patients did not receive anticoagulant therapy. D-dimers were uniformly increased. During hospitalization 2 patients suffered thrombosis, 3 experienced bleeding and 12 died. TG parameters from anticoagulated COVID-19 patients did not significantly differ from the values obtained from non-anticoagulated healthy controls. Patients who received higher than prophylactic doses of anticoagulant therapy had increased lag time (P = 0.003), lower endogenous thrombin potential (ETP) (P = 0.037), and a reduced peak height (P = 0.006). ETP correlated with the SIC score (P = 0.038). None of the TG parameters correlated with the SOFA score or were associated with mortality.Conclusion: TG was not associated with disease severity among patients hospitalized with COVID-19. However, a correlation between ETP and the SIC score was noted and deserves attention.

Automated summary

This study analyzed the correlation between thrombin generation (TG) capacity in COVID-19 patients and disease severity and clinical outcomes. The results showed that TG was not associated with disease severity, but endogenous thrombin potential (ETP) correlated with sepsis-induced coagulopathy (SIC) score. This finding is worth noting.