Evaluation of coagulation with TEG in patients diagnosed COVID-19

Authors: HÜLYA VATANSEV, MEHMET ALİ KARASELEK, RESUL YILMAZ, SERKAN KÜÇÇÜKTÜRK, AHMET TOPAL, ŞEBNEM YOSUNKAYA, ADEM KÜÇÜK, CELALETTİN VATANSEV

Abstract: Background and aim: A high D-dimer level may indicate the risk of coagulopathy and mortality in COVID-19 patients. Thromboelastography (TEG) is a test that evaluates clot formation and fibrinolysis in real-time, unlike routine coagulation tests. The study aimed to investigate the coagulation process with TEG in patients diagnosed with COVID-19. Materials and Methods: The study was performed at our university hospital, chest diseases outpatient clinic as a cross-section study. A total of 51 patients with 23 high D-dimer levels group (HDG) and 28 low D-dimers group (LDG) were included in the study. TEG analysis was performed at the pretreatment evaluation in these two groups. Results: D-dimer and fibrinogen levels of the HDG were higher than those of the LDG (550 vs. 90 ng/mL, p < 0.001; 521 vs. 269 mg/ dL, p < 0.001, respectively). In TEG analysis, HDG's R and K values were lower than LDG, and HDG's Angle, MA, and CI values were higher than LDG (p = 0.037; p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). ROC curve analysis suggested that the optimum TEG parameters cut-off points for thrombosis risk were as below: for K was ≤2.1 min, for R was ≤6.1 min, for Angle was >62°, MA was 60.4 mm. Conclusion: Our study showed that the risk of thrombosis might increase in COVID-19 patients who are not hospitalized in the intensive care unit. Thrombosis risk should be investigated with TEG analysis and laboratory tests in every patient diagnosed with COVID-19, and treatment should be started for risky patients.

Keywords: Thromboelastography, COVID-19, D-Dimer, coagulopathy, thrombosis

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