Association between Thrombin Generation and Clinical Characteristics in COVID-19 Patients

Abstract

<b><i>Introduction:</i></b> Coronavirus disease 2019 (COVID-19) disease is associated with coagulopathy and an increased risk of thrombosis. An association between thrombin generation (TG) capacity, disease severity, and outcomes has not been well described. <b><i>Methods:</i></b> We assessed the correlation of TG with sequential organ failure assessment (SOFA) and sepsis-induced coagulopathy (SIC) scores and clinical outcomes by analysis of plasma samples obtained from hospitalized COVID-19 patients. <b><i>Results:</i></b> 32 patients (68.8% male), whose median age was 69 years, were assessed, of whom only 3 patients did not receive anticoagulant therapy. D-dimers were uniformly increased. During hospitalization, 2 patients suffered thrombosis, 3 experienced bleeding, and 12 died. TG parameters from anticoagulated COVID-19 patients did not significantly differ from the values obtained from non-anticoagulated healthy controls. Patients who received higher than prophylactic doses of anticoagulant therapy had increased lag time (<i>p</i> = 0.003), lower endogenous thrombin potential (ETP) (<i>p</i> = 0.037), and a reduced peak height (<i>p</i> = 0.006). ETP correlated with the SIC score (<i>p</i> = 0.038). None of the TG parameters correlated with the SOFA score or were associated with mortality. <b><i>Conclusion:</i></b> TG was not associated with disease severity among patients hospitalized with COVID-19. However, a correlation between ETP and the SIC score was noted and deserves attention.