PB0869 - Thrombin generation in acute period of COVID-19

Background: Patients with COVID-19 have an increased incidence of venous thromboembolism than expect in other severely ill patients. Studying of the hypercoagulability caused by coronavirus infection and informative tests searching for estimation of hemostasis state can be useful for monitoring antithrombotic therapy and decreasing of thrombosis complications.

Aims: To estimate the state of hemostasis in COVID-19 patients using a thrombin generation test.

Methods: The study included 88 patients with severe and semi-severe COVID-19. All patients were added enoxaparin sodium 0,8 ml per day as antithrombotic prophylaxis Thrombin generation was assessed by CAT according to Hemker et al. Measure was conducted in platelet poor plasma with or without presence of thrombomodulin. The following parameters were determined: endogenous thrombin potential (ETP, nM*min), peak thrombin (Peak, nM). Sensitivity ETP and Peak for thrombomodulin were calculated as percent of decreasing of these parameters after adding thrombomodulin to the assay. Reduction of sensitivity for thrombomodulin indicates dysfunction of anticoagulant protein C system.
STATISTICA 12.0 package was used. Results are presented as median with 95% confidence intervals, p< 0.05 was considered statistically significant (*).

Results: Results are presented in the table. Thrombin generation parameters have significant distinctions between patients and controls. ETP, Peak thrombin were higher, Sensitivity ETP and Peak for thrombomodulin were vastly lower in COVID-19 patients.

Conclusion(s): Patients with COVID-19, despite of antithrombotic prophylaxis, have significant thrombin generation rise and low efficiency of protein C anticoagulant system. It may suggest inefficiency of unified anticoagulant prophylaxis and can be associated with thrombotic complication.