PB0046 - Association between thrombin generation and clinical characteristics in COVID-19 patients

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Omri Cohen, MD

Senior physician
Sheba medical center, Tel Aviv University
Holon, HaMerkaz, Israel

Co-Author(s)

NL

Nitsan Landau

Resident
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
EA

Einat Avishai

Research Assistant, Molecular Biology Unit, Coagulation Laboratory, National Hemophilia Center and T
Tel Aviv University
Tel Aviv, HaMerkaz, Israel
TB

Tami Barazani

Head, research unit
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
IB

Ivan Budnik

MD Phd
University of IOWA
Iowa city, Iowa, United States
TL

Tami Livnat

Head - Basic Research Laboratory, Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheb
Tel Aviv University
Tel Aviv, Tel Aviv, Israel
KA

Keren Asraf

Laboratory technician
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
RD

Ram Doolman

Head of laboratory services, Sheba medical center
Bar Ilan University
Ramat Gan, HaMerkaz, Israel
OE

Orly Efros

Senior physician
Sheba medical center, Tel Aviv University
Tel Hashomer, Tel Aviv, Israel
EO

Efros Orly

Senior physician
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
UM

Uri Manor

Resident
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
EM

Eyal Meltzer

Senior physician
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
GS

Gad Segal

Head, department of Internal Medicine I
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
GR

Galia Rahav

Head, Infectious disease unit
Sheba medical center, Tel Aviv University
Ramat Gan, HaMerkaz, Israel
Gili Kenet, MD

Director
The National Hemophilia Center, and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
Yehud-Monosson, HaMerkaz, Israel

Background: COVID-19 disease is associated with coagulopathy and an increased risk of thrombosis.
A high thrombin generation (TG) capacity has been reported among patients, however, association between TG, disease severity and outcomes has not been well described.

Aims: To assess the correlation of TG with the sequential organ failure assessment (SOFA) and sepsis-induced coagulopathy (SIC) scores and clinical outcomes in COVID-19 patients.

Methods: Plasma samples of hospitalized COVID-19 patients were sequentially collected and analyzed for TG. Demographic and clinical data was retrieved from medical records. SOFA and SIC scores were calculated for all patients. Statistical analysis was performed using GraphPad Prism (version 7.0), USA.

Results: Thirty-two patients (69% male), whose median age was 69 years were assessed. Among patients’ comorbidities hypertension, cardiovascular illness, dyslipidemia and malignancy prevailed. Only 3 patients did not receive anticoagulant therapy.
The median (IQR; range) SOFA and SIC scores of our patients were 3 (2,6; 0-10) and 3 (2,4; 0-6), respectively. D-dimers were uniformly increased. During hospitalization 2 patients had a thrombosis, 3 suffered a bleeding and 12 died.
Initial Lag time, endogenous thrombin potential (ETP) and peak height (PH) of our patients did not significantly differ from the values obtained from non-anticoagulated healthy controls. Nevertheless, patients who received higher than prophylactic doses of anticoagulant therapy had increased lag time (p=0.003), lower ETP (p=0.037) and a reduced PH (p=0.006).
ETP and PH were slightly increased among patients with severe and critical COVID-19 as compared with mild and moderate patients (Figure 1).
ETP correlated with the SIC score (p=0.038), however there was no correlation between any of the TG parameters and the SOFA score (Figure 2) or mortality.

Conclusion(s): Thrombin generation could not predict disease severity among patients hospitalized with COVID-19, however a correlation between ETP and the SIC score was noted and deserves attention.