コモリ　マキコ   KOMORI Makiko   小森　万希子    所属   医学部 医学科（附属足立医療センター）    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Evaluation of coagulation status using clot waveform analysis in general ward patients with COVID-19.
掲載誌名	正式名：Journal of thrombosis and thrombolysis 略　 称：J Thromb Thrombolysis ISSNコード：1573742X/09295305
掲載区分	国外
巻・号・頁	pp.epub-ahead of print
著者・共著者	Ichikawa Junko†, Okazaki Ryouta, Fukuda Tomoki, Ono Takuya, Ishikawa Motonao, Komori Makiko
担当区分	最終著者
発行年月	2021/07
概要	Coronavirus disease (COVID-19)-related systemic cytokine response induces the production of procoagulant factors, which predisposes patients to a prothrombotic state. Viscoelastic testing can identify the degree of hypercoagulability, which is related to outcomes. We aimed to study the changes in clot waveform analysis (CWA) parameters in COVID-19 patients on hospital admission compared to those in a group of healthy individuals. We conducted a retrospective study of COVID-19 patients admitted to general wards and evaluated demographic and clinical parameters as well as laboratory parameters, including coagulation parameters. CWA data from patients (n = 62) with COVID-19 prior to the initiation of anticoagulation therapy were compared with those from healthy controls (n = 67). The measured CWA parameters were min1, min2, max2, and delta change. CWA, fibrinogen, and D-dimer values were higher in COVID-19 patients than in healthy controls (p < 0.001). CWA profiles were consistent with hypercoagulability and characterized by an increase in density, velocity, and acceleration of clot formation. Activated partial thromboplastin time, fibrinogen, D-dimer, and C-reactive protein (CRP) values were higher in patients in whom all CWA parameters were raised than in patients with just a few elevated CWA parameters, while Sequential Organ Failure Assessment scores, prothrombin time, fibrin degradation product levels and platelet counts did not differ between the two groups. CWA variables showed hypercoagulopathy on admission in COVID-19 patients who were hospitalized in the general ward, and this pattern was more pronounced in critically ill patients with elevated fibrinogen, D-dimer, and CRP levels. Our results may help identify patients at high risk of thromboembolism.
DOI	10.1007/s11239-021-02499-z
PMID	34263423