PB0603 - The assessment of ROTEM test in patients with critical form of COVID-19

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Viola M. Popov, PhD

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania

Co-Author(s)

LI

Lelia M. Iliescu

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
AB

Adriana Badea

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
CP

Catalina Pirvu

MD
Colentina Clinical Hospital
Bucharest, Bucuresti, Romania
AG

Andra Grigorie

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
OC

Oana Constantin

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
MB

Mihaela Dana Badoiu Niculae

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
AC

Andreea Calen

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
AN

Andra Nichita

MD
Colentina Clinical Hospital
Bucharest, Bucuresti, Romania
AR

Ana Rus

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania
MA

Mihaela Andreescu

MD
Colentina Hospital Bucharest
Bucharest, Bucuresti, Romania

Background: Patients with comorbidities could have severe COVID-19 outcomes. Thrombosis or hemorrhages were frequently reported during COVID-19 evolution

Aims: The study evaluated the role of ROTEM in the identification of patients with a high risk of vascular complications

Methods: We analyzed clinical, ROTEM, and laboratory data of 80 patients admitted to the intensive care unit (ICU) Department of our hospital, during 2020-2021.

Results: Thrombosis was diagnosed in 26 cases (27.96%) and was more frequent in patients with severe pneumonia and ARDS, Chi-squared 3.55, p=0.05. Hemorrhages were identified in 21 cases (22,58%) and were less frequent in patients with severe ARDS, Chi-squared=4.67, p=0.03. ROTEM analyses were focused on ExTEM, InTEM, and FibTEM clotting time (CT), clot amplitudes after five and ten minutes (A5/A10), maximum clot firmness (MCF), and maximum lysis (ML). In the ExTEM median CT (eCT) value was 90.5 (50-207) s in patients with severe ARDS vs 75(58-571)s in patients with mild/medium ARDS, p=0.02; A5 44 (16-68) in patient with thrombosis vs. 53 (12-69) in patient without thrombosis; ML 6 (0-104) in patients with sepsis vs 8 (0-15) in patient without sepsis, p=0.04.The median FibTEM CT (fCT) was 91 (53-7913) s in patients with severe ARDS vs 76 (52-8203)s in patients with mild/medium ARDS, p=0.009;there were a significant correlation with ferritin level, rho=0.22, p= 0.05. An increasing value of fCT during COVID-19 evolution was observed especially in the critical form of COVID-19. Lymphopenia was significant in patient with severe ARDS 0,48 x 1000/uL (0.02-8.03) vs 0.67 x 1000/uL (0.14-9.09) identified in patients with mild/medium ARDS, p=0.05; it was not obtained significant correlations between lab test and ROTEM results.

Conclusion(s): The ROTEM test suggests showing hypercoagulability probably due to severe inflammation. Patients with a critical form of COVID-19 developed thrombotic complications more frequently than hemorrhages. We have to check these results in large cohorts of patients