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Pilot study to evaluate hypercoagulation and inflammation using rotational thromboelastometry and calprotectin in COVID-19 patients

Pilot study to evaluate hypercoagulation and inflammation using rotational thromboelastometry and calprotectin in COVID-19 patients
Pilot study to evaluate hypercoagulation and inflammation using rotational thromboelastometry and calprotectin in COVID-19 patients

Introduction Abnormal coagulation and inflammation are hallmarks of SARs-COV-19. Stratifying affected patients on admission to hospital may help identify those who at are risk of developing severe disease early on. Rotational Thromboelastometry (ROTEM) is a point of care test that can be used to measure abnormal coagulation and calprotectin is a measure of inflammation. Aim Assess if ROTEM can measure hypercoagulability on admission and identify those who will develop severe disease early on. Assess if calprotectin can measure inflammation and if there is a correlation with ROTEM and calprotectin. Methods COVID-19 patients were recruited on admission and ROTEM testing was undertaken daily for a period of 7 days. Additionally inflammatory marker calprotectin was also tested for the same period. Results 33 patients were recruited to the study out of which 13 were admitted to ITU and 20 were treated on the ward. ROTEM detected a hypercoagulable state on admission but did not stratify between those admitted to a ward or escalated to ITU. Calprotectin levels were raised but there was no statistical difference (p = 0.73) between patients admitted to a ward or escalated to ITU. Significant correlations were observed between FIBA5 (r = 0.62; p<0.00), FIBCFT (r = -0.57; p<0.00), FIBMCF (r = 0.64; p<0.00) and INMCF (r = 0.57; p<0.00) and calprotectin. Conclusion COVID-19 patients were hypercoagulable on admission. The correlations between ROTEM and calprotectin underline the interactions between inflammation and coagulation.

1932-6203
Stanford, Sophia
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Roy, Ashok
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Rea, Catherine
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Harris, Ben
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Ashton, Antony
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Mangles, Sarah
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Everington, Tamara
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Taher, Rayan
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Burns, Daniel
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Smith, Emily Arbuthnot
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Cecil, Tom
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Stanford, Sophia
ea11cec4-d952-4e42-b44c-70e02eb3ec66
Roy, Ashok
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Rea, Catherine
0d517a35-f0e4-436f-a61b-d6eab4a50d7f
Harris, Ben
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Ashton, Antony
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Mangles, Sarah
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Everington, Tamara
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Taher, Rayan
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Burns, Daniel
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Smith, Emily Arbuthnot
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Cecil, Tom
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Stanford, Sophia, Roy, Ashok, Rea, Catherine, Harris, Ben, Ashton, Antony, Mangles, Sarah, Everington, Tamara, Taher, Rayan, Burns, Daniel, Smith, Emily Arbuthnot and Cecil, Tom (2023) Pilot study to evaluate hypercoagulation and inflammation using rotational thromboelastometry and calprotectin in COVID-19 patients. PLoS ONE, 18 (1 January), [e0269738]. (doi:10.1371/journal.pone.0269738).

Record type: Article

Abstract

Introduction Abnormal coagulation and inflammation are hallmarks of SARs-COV-19. Stratifying affected patients on admission to hospital may help identify those who at are risk of developing severe disease early on. Rotational Thromboelastometry (ROTEM) is a point of care test that can be used to measure abnormal coagulation and calprotectin is a measure of inflammation. Aim Assess if ROTEM can measure hypercoagulability on admission and identify those who will develop severe disease early on. Assess if calprotectin can measure inflammation and if there is a correlation with ROTEM and calprotectin. Methods COVID-19 patients were recruited on admission and ROTEM testing was undertaken daily for a period of 7 days. Additionally inflammatory marker calprotectin was also tested for the same period. Results 33 patients were recruited to the study out of which 13 were admitted to ITU and 20 were treated on the ward. ROTEM detected a hypercoagulable state on admission but did not stratify between those admitted to a ward or escalated to ITU. Calprotectin levels were raised but there was no statistical difference (p = 0.73) between patients admitted to a ward or escalated to ITU. Significant correlations were observed between FIBA5 (r = 0.62; p<0.00), FIBCFT (r = -0.57; p<0.00), FIBMCF (r = 0.64; p<0.00) and INMCF (r = 0.57; p<0.00) and calprotectin. Conclusion COVID-19 patients were hypercoagulable on admission. The correlations between ROTEM and calprotectin underline the interactions between inflammation and coagulation.

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Accepted/In Press date: 21 December 2022
Published date: 6 January 2023
Additional Information: Publisher Copyright: Copyright: © 2023 Stanford et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Identifiers

Local EPrints ID: 475134
URI: http://eprints.soton.ac.uk/id/eprint/475134
ISSN: 1932-6203
PURE UUID: 430419ef-04a0-43ac-bce5-9dfff7885d01
ORCID for Daniel Burns: ORCID iD orcid.org/0000-0001-6976-1068

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Date deposited: 10 Mar 2023 17:42
Last modified: 17 Mar 2024 03:46

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Contributors

Author: Sophia Stanford
Author: Ashok Roy
Author: Catherine Rea
Author: Ben Harris
Author: Antony Ashton
Author: Sarah Mangles
Author: Tamara Everington
Author: Rayan Taher
Author: Daniel Burns ORCID iD
Author: Emily Arbuthnot Smith
Author: Tom Cecil

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