key: cord-0832925-3070a2cy
authors: Raval, Jay S.; Burnett, Allison E.; Rollins‐Raval, Marian A.; Griggs, Joseph R.; Rosenbaum, Lizabeth; Nielsen, Nathan D.; Harkins, Michelle S.
title: Viscoelastic testing in COVID‐19: a possible screening tool for severe disease?
date: 2020-05-22
journal: Transfusion
DOI: 10.1111/trf.15847
sha: b77e7ce03a47bc5a9f01fdfd97c7ad6baf6a6860
doc_id: 832925
cord_uid: 3070a2cy

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(79 mm), and FIBTEM (58 mm) tracings (normal 52-70 mm, 51-72 mm, and 10-24 mm, respectively), and clot formation time was shortened on the EXTEM tracing (39 seconds, normal 48-127 seconds) with an increased α angle (82°, normal 65-80°). The patient was placed on 7500 units of subcutaneous unfractionated heparin every 8 hours for thrombosis prevention based on his critical illness and viscoelastic testing results. The patient still requires mechanical ventilation and vasopressor support; he has not developed any overt thrombotic or bleeding events, and D-dimers have decreased (1294 ng/mL FEU).

These preliminary findings suggest that viscoelastic testing may have a role in rapidly identifying patients with severe COVID-19. Other viscoelastic methods of assessing clot firmness could also be used in COVID-19, such as thromboelastography and resonance sonorheometry. 8, 9 Measuring D-dimer or fibrinogen concentrations could assess this pathologic phenomenon if viscoelastic testing was unavailable. 10, 11 The utility of viscoelastic testing in COVID-19 needs to be further assessed to better understand the usefulness and limitations of this technology in these critically ill patients with a hypercoagulable state. 12 

World Health Organization. Coronavirus disease (COVID-19) pandemic

Practical diagnosis and treatment of suspected venous thromboembolism during COVID-19 Pandemic

ISTH interim guidance on recognition and management of coagulopathy in COVID-19

COVID-19: consider cytokine storm syndromes and immunosuppression

The pathogenesis and treatment of the 'cytokine storm' in COVID-19

D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis

The double hazard of bleeding and thrombosis in hemostasis from a clinical point of view: a global assessment by Rotational Thromboelastometry (ROTEM)

Hypercoagulability of COVID-19 patients in intensive care unit. A report of thromboelastography findings and other parameters of hemostasis

A comparative study of SEER sonorheometry versus standard coagulation tests, rotational thromboelastometry, and multiple electrode aggregometry in cardiac surgery

Prominent changes in blood coagulation of patients with SARS-CoV-2 infection

Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia

The effect of sepsis and septic shock on the viscoelastic properties of clot quality and mass using rotational thromboelastometry: a prospective observational study

The authors have disclosed no conflicts of interest.