Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia
Hypercoagulation is central to the pathogenesis of acute and post-acute COVID-19. This prospective observational study explored whether rotational thromboelastometry (ROTEM), a method that unveils coagulation status, predicts outcomes of hospitalized patients with COVID-19 pneumonia. We investigated...
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2024-12-01
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| author | Natasa-Eleni Loutsidi Marianna Politou Vassilios Vlahakos Dimitrios Korakakis Theodora Kassi Asimina Nika Abraham Pouliakis Konstantinos Eleftheriou Evangelos Balis Apostolos G. Pappas Ioannis Kalomenidis |
| author_facet | Natasa-Eleni Loutsidi Marianna Politou Vassilios Vlahakos Dimitrios Korakakis Theodora Kassi Asimina Nika Abraham Pouliakis Konstantinos Eleftheriou Evangelos Balis Apostolos G. Pappas Ioannis Kalomenidis |
| author_sort | Natasa-Eleni Loutsidi |
| collection | DOAJ |
| description | Hypercoagulation is central to the pathogenesis of acute and post-acute COVID-19. This prospective observational study explored whether rotational thromboelastometry (ROTEM), a method that unveils coagulation status, predicts outcomes of hospitalized patients with COVID-19 pneumonia. We investigated 62 patients using ROTEM that was conducted at enrollment, clinical deterioration, discharge and follow-up visits 1 and 3 months post-discharge. A hypercoagulable ROTEM was more common at clinical deterioration than at enrollment and the levels of hypercoagulable ROTEM indices correlated with the clinical severity score. Hypercoagulable ROTEM at enrollment was not associated with in-hospital death. Patients with hypercoagulable ROTEM at enrollment, discharge and 1 month post-discharge had an increased risk of persistent symptoms 1 and 3 months after discharge. Patients with hypercoagulable ROTEM at enrollment, discharge, and 1 month after discharge were more likely to have lung diffusion capacity (DLco) impairment 3 months after discharge. High levels of hypercoagulable ROTEM indices were associated with the increased risk of persistent symptoms at later stages of the disease. In a multivariate analysis, (i) hypercoagulable ROTEM at discharge and female gender were linked to the presence of symptoms at one month post-discharge, (ii) hypercoagulable ROTEM at one month after discharge was linked to the presence of symptoms at three months post-discharge, (iii) hypercoagulable ROTEM at enrollment and at discharge and female gender were linked to the presence of impaired DLco at three months post-discharge. Excessive coagulation may contribute to long-COVID pathogenesis and ROTEM findings during hospitalization may predict post-acute-COVID-19 sequelae in patients with COVID-19-related pneumonia. |
| format | Article |
| id | doaj-art-613dbd228898474fb88e077b4b463409 |
| institution | Kabale University |
| issn | 1999-4915 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj-art-613dbd228898474fb88e077b4b4634092024-12-27T14:59:14ZengMDPI AGViruses1999-49152024-12-011612191610.3390/v16121916Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related PneumoniaNatasa-Eleni Loutsidi0Marianna Politou1Vassilios Vlahakos2Dimitrios Korakakis3Theodora Kassi4Asimina Nika5Abraham Pouliakis6Konstantinos Eleftheriou7Evangelos Balis8Apostolos G. Pappas9Ioannis Kalomenidis10Haematology-Lymphomas Department and Bone Marrow Transplant Unit, “Evangelismos” General Hospital, 10676 Athens, GreeceHematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece1st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “Evangelismos” General Hospital, 10676 Athens, GreeceHematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, GreeceHematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, GreeceHematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece2nd Department of Pathology, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, 12462 Chaidari, Greece1st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “Evangelismos” General Hospital, 10676 Athens, GreeceDepartment of Pulmonary Medicine, “Evangelismos” Hospital, 10676 Athens, Greece1st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “Evangelismos” General Hospital, 10676 Athens, Greece1st Department of Critical Care and Pulmonary Medicine, School of Medicine, National and Kapodistrian University of Athens, “Evangelismos” General Hospital, 10676 Athens, GreeceHypercoagulation is central to the pathogenesis of acute and post-acute COVID-19. This prospective observational study explored whether rotational thromboelastometry (ROTEM), a method that unveils coagulation status, predicts outcomes of hospitalized patients with COVID-19 pneumonia. We investigated 62 patients using ROTEM that was conducted at enrollment, clinical deterioration, discharge and follow-up visits 1 and 3 months post-discharge. A hypercoagulable ROTEM was more common at clinical deterioration than at enrollment and the levels of hypercoagulable ROTEM indices correlated with the clinical severity score. Hypercoagulable ROTEM at enrollment was not associated with in-hospital death. Patients with hypercoagulable ROTEM at enrollment, discharge and 1 month post-discharge had an increased risk of persistent symptoms 1 and 3 months after discharge. Patients with hypercoagulable ROTEM at enrollment, discharge, and 1 month after discharge were more likely to have lung diffusion capacity (DLco) impairment 3 months after discharge. High levels of hypercoagulable ROTEM indices were associated with the increased risk of persistent symptoms at later stages of the disease. In a multivariate analysis, (i) hypercoagulable ROTEM at discharge and female gender were linked to the presence of symptoms at one month post-discharge, (ii) hypercoagulable ROTEM at one month after discharge was linked to the presence of symptoms at three months post-discharge, (iii) hypercoagulable ROTEM at enrollment and at discharge and female gender were linked to the presence of impaired DLco at three months post-discharge. Excessive coagulation may contribute to long-COVID pathogenesis and ROTEM findings during hospitalization may predict post-acute-COVID-19 sequelae in patients with COVID-19-related pneumonia.https://www.mdpi.com/1999-4915/16/12/1916ROTEMCOVID-19pneumonialong-COVIDDLcothromboelastometry |
| spellingShingle | Natasa-Eleni Loutsidi Marianna Politou Vassilios Vlahakos Dimitrios Korakakis Theodora Kassi Asimina Nika Abraham Pouliakis Konstantinos Eleftheriou Evangelos Balis Apostolos G. Pappas Ioannis Kalomenidis Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia Viruses ROTEM COVID-19 pneumonia long-COVID DLco thromboelastometry |
| title | Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia |
| title_full | Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia |
| title_fullStr | Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia |
| title_full_unstemmed | Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia |
| title_short | Hypercoagulable Rotational Thromboelastometry During Hospital Stay Is Associated with Post-Discharge DLco Impairment in Patients with COVID-19-Related Pneumonia |
| title_sort | hypercoagulable rotational thromboelastometry during hospital stay is associated with post discharge dlco impairment in patients with covid 19 related pneumonia |
| topic | ROTEM COVID-19 pneumonia long-COVID DLco thromboelastometry |
| url | https://www.mdpi.com/1999-4915/16/12/1916 |
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