More Severe Hypercoagulable State in Acute COVID-19 Pneumonia as Compared With Other Pneumonia

Luca Spiezia; Elena Campello; Marco Cola; Francesco Poletto; Lorenzo Cerruti; Anna Poretto; Chiara Simion; Annamaria Cattelan; Roberto Vettor; Paolo Simioni

doi:10.1016/j.mayocpiqo.2020.09.002

More Severe Hypercoagulable State in Acute COVID-19 Pneumonia as Compared With Other Pneumonia

Mayo Clin Proc Innov Qual Outcomes. 2020 Dec;4(6):696-702. doi: 10.1016/j.mayocpiqo.2020.09.002. Epub 2020 Oct 1.

Authors

Affiliations

¹ General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Padova, Italy.
² Infectious Diseases, Padova University Hospital, Padova, Italy.
³ Internal Medicine 3, Department of Medicine, Padova University Hospital, Padova, Italy.

Abstract

Objective: To conduct a comprehensive evaluation of coagulation profiles-via traditional and whole blood thromboelastometry tests-in coronavirus disease 2019 (COVID-19)-positive vs COVID-19-negative patients admitted to medical wards for acute pneumonia.

Patients and methods: We enrolled all consecutive patients admitted to internal medicine wards of Padova University Hospital between 7 March and 30 April, 2020, for COVID-19-related pneumonia (cases) vs non-COVID-19 pneumonia (controls). A group of healthy individuals acted as baseline for thromboelastometry parameters.

Results: Fifty-six cases (mean age, 64±15 years; male/female, 37/19) and 56 controls (mean age, 76±11 years; male/female, 35/21) were enrolled. Cases and controls exhibited markedly hypercoagulable thromboelastometry profiles vs healthy individuals, mainly characterized by a significantly shorter propagation phase of coagulation (clot formation time) and significantly increased maximum clot firmness (P<.001 for all comparisons). Patients with COVID-19 pneumonia had significantly shorter clot formation time and higher maximum clot firmness (P<.01 and P<.05, respectively, for all comparisons) than did controls.

Conclusion: Patients admitted to internal medicine wards for COVID-19 pneumonia presented a markedly prothrombotic state, which seems peculiar to COVID-19 rather than pneumonia itself.

Keywords: CFT, clot formation time; COVID-19, coronavirus disease 2019; CT, clotting time; MCF, maximum clot firmness; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.