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Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review.

Publication ,  Journal Article
Bareille, M; Hardy, M; Douxfils, J; Roullet, S; Lasne, D; Levy, JH; Stépanian, A; Susen, S; Frère, C; Lecompte, T; Mullier, F
Published in: J Clin Med
April 16, 2021

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until 31st December 2020. VET methods and parameters, and patients' features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.

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Published In

J Clin Med

DOI

ISSN

2077-0383

Publication Date

April 16, 2021

Volume

10

Issue

8

Location

Switzerland

Related Subject Headings

  • 32 Biomedical and clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Chicago
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MLA
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Bareille, M., Hardy, M., Douxfils, J., Roullet, S., Lasne, D., Levy, J. H., … Mullier, F. (2021). Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review. J Clin Med, 10(8). https://doi.org/10.3390/jcm10081740
Bareille, Marion, Michaël Hardy, Jonathan Douxfils, Stéphanie Roullet, Dominique Lasne, Jerrold H. Levy, Alain Stépanian, et al. “Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review.J Clin Med 10, no. 8 (April 16, 2021). https://doi.org/10.3390/jcm10081740.
Bareille M, Hardy M, Douxfils J, Roullet S, Lasne D, Levy JH, et al. Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review. J Clin Med. 2021 Apr 16;10(8).
Bareille, Marion, et al. “Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review.J Clin Med, vol. 10, no. 8, Apr. 2021. Pubmed, doi:10.3390/jcm10081740.
Bareille M, Hardy M, Douxfils J, Roullet S, Lasne D, Levy JH, Stépanian A, Susen S, Frère C, Lecompte T, Mullier F. Viscoelastometric Testing to Assess Hemostasis of COVID-19: A Systematic Review. J Clin Med. 2021 Apr 16;10(8).

Published In

J Clin Med

DOI

ISSN

2077-0383

Publication Date

April 16, 2021

Volume

10

Issue

8

Location

Switzerland

Related Subject Headings

  • 32 Biomedical and clinical sciences
  • 1103 Clinical Sciences