Thromboelastography as a Predictor of Mortality in Severe COVID-19
نویسندگان
1 Clinical Pathology Specialist Programme, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
2 Clinical Pathology Specialist Programme, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
3 Department of Clinical Pathology, Faculty of Medicine, Universitas Negeri Yogyakarta, Yogyakarta, Indonesia
4 Clinical Pathology Specialist Programme, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
5 Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
6 Departement of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
7 Clinical Pathology Specialist Programme, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
8 Clinical Pathology Specialist Programme, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
9 Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
10 Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
doi
10.26655/JMCHEMSCI.2024.9.7چکیده
Coronavirus disease 2019 (COVID-19) was examined to cause abnormalities within the hemostatic system. Viscoelastic tests, such as thromboelastography (TEG), were employed to evaluate the function of specific components involved in the hemostatic process. This allowed for the identification of coagulopathy, which has the potential to serve as a predictor of mortality in COVID-19 patients. This research aims to evaluate TEG as a predictor of 30-day mortality in patients with severe COVID-19. This study was a prospective observational cohort study conducted from April 2021 through November 2021. TEG and routine coagulation tests were performed during the first 24 h when COVID-19 patients were admitted into the intensive care unit. Coagulation status was determined by using TEG and analysed based on 30-day mortality. Out of the 75 patients evaluated with TEG, 33 died within 30 days (44%), 23 patients exhibited hyper-coagulation (30.7%), 5 patients had hypocoagulation (6.7%), and 47 patients showed normal coagulation (62.7%). Kaplan–Meier analysis revealed that the risk of mortality within 30 days was higher in hyper-coagulation and hypocoagulation compared to the normal coagulation groups. In the hypocoagulation group, the hazard ratio was 3.27 (95% CI 1.141–9.372; p = 0.027), while in the hyper-coagulation group, it was 1.64 (95% CI 0.794–3.379; p = 0.181). Using the TEG as a tool for examination to assess the coagulation status to predict mortality in severe COVID-19 cases, the research finds out that the group of patients exhibiting hypocoagulation was at a 3.27-fold high risk of mortality within 30 days in comparison with the group showing normal coagulation.
