tetano
Editor, Senior Moderator
Thromb Res
. 2023 Dec 21:234:21-31.
doi: 10.1016/j.thromres.2023.12.009. Online ahead of print. Whole blood viscoelastic testing profile and mortality in patients hospitalized with acute COVID-19 pneumonia: A systematic review and meta-analysis
Luca Spiezia[SUP] 1 [/SUP], Elena Campello[SUP] 2 [/SUP], Paolo Simioni[SUP] 2 [/SUP], Mario I Lumbreras-Marquez[SUP] 3 [/SUP]
Affiliations
Background: Several studies have evaluated the possible association between whole blood viscoelastic testing (VET) parameters in patients hospitalized for acute Coronavirus disease 2019 (COVID-19) pneumonia and mortality. A few studies found no significant differences between survivors and non-survivors, though other studies identified potential predictors of COVID-19-related mortality. We conducted a systematic review and meta-analysis of the literature to evaluate the possible association between standard thromboelastometry/graphy parameters and mortality in patients hospitalized for acute COVID-19 pneumonia.
Methods: Relevant studies were searched through MEDLINE, EMBASE, and Google Scholar from their inception until 15th June 2023. We aimed to identify any study including: i) adults admitted to intensive care units (ICU) or medicine wards (MW) for acute COVID-19 pneumonia; ii) viscoelastic testing; iii) mortality.
Results: We included 13 studies: nine prospective and four retrospective, 231 (30.4 %) non-survivors and 528 (69.6 %) survivors. Mortality rates ranged from 12.8 % to 67.5 %. The studies using the TEG apparatus found a significant difference in K time in the Kaolin test among survivors vs. non-survivors (mean difference [MD] 0.20, 95 % confidence interval [CI] 0.12, 0.28, I[SUP]2[/SUP] 0%). The studies using the rotational thromboelastometry apparatus found a significant difference in CT-INTEM (MD -17.14, 95 % CI -29.23, -5.06, I[SUP]2[/SUP] 0%) and LI60-EXTEM (MD -1.00, 95 % CI -1.00, -1.00, I[SUP]2[/SUP] 0%) assays among survivors vs. non-survivors.
Conclusion: We identified no specific hypercoagulable or hypocoagulable profile associated with mortality in patients with COVID-19-related pneumonia. Large prospective studies are needed to explore the possible prognostic role of VET in this subset of patients.
Keywords: Acute COVID-19 pneumonia; Metaanalysis; Mortality; Whole blood viscoelastic testing profile.
. 2023 Dec 21:234:21-31.
doi: 10.1016/j.thromres.2023.12.009. Online ahead of print. Whole blood viscoelastic testing profile and mortality in patients hospitalized with acute COVID-19 pneumonia: A systematic review and meta-analysis
Luca Spiezia[SUP] 1 [/SUP], Elena Campello[SUP] 2 [/SUP], Paolo Simioni[SUP] 2 [/SUP], Mario I Lumbreras-Marquez[SUP] 3 [/SUP]
Affiliations
- PMID: 38142487
- DOI: 10.1016/j.thromres.2023.12.009
Background: Several studies have evaluated the possible association between whole blood viscoelastic testing (VET) parameters in patients hospitalized for acute Coronavirus disease 2019 (COVID-19) pneumonia and mortality. A few studies found no significant differences between survivors and non-survivors, though other studies identified potential predictors of COVID-19-related mortality. We conducted a systematic review and meta-analysis of the literature to evaluate the possible association between standard thromboelastometry/graphy parameters and mortality in patients hospitalized for acute COVID-19 pneumonia.
Methods: Relevant studies were searched through MEDLINE, EMBASE, and Google Scholar from their inception until 15th June 2023. We aimed to identify any study including: i) adults admitted to intensive care units (ICU) or medicine wards (MW) for acute COVID-19 pneumonia; ii) viscoelastic testing; iii) mortality.
Results: We included 13 studies: nine prospective and four retrospective, 231 (30.4 %) non-survivors and 528 (69.6 %) survivors. Mortality rates ranged from 12.8 % to 67.5 %. The studies using the TEG apparatus found a significant difference in K time in the Kaolin test among survivors vs. non-survivors (mean difference [MD] 0.20, 95 % confidence interval [CI] 0.12, 0.28, I[SUP]2[/SUP] 0%). The studies using the rotational thromboelastometry apparatus found a significant difference in CT-INTEM (MD -17.14, 95 % CI -29.23, -5.06, I[SUP]2[/SUP] 0%) and LI60-EXTEM (MD -1.00, 95 % CI -1.00, -1.00, I[SUP]2[/SUP] 0%) assays among survivors vs. non-survivors.
Conclusion: We identified no specific hypercoagulable or hypocoagulable profile associated with mortality in patients with COVID-19-related pneumonia. Large prospective studies are needed to explore the possible prognostic role of VET in this subset of patients.
Keywords: Acute COVID-19 pneumonia; Metaanalysis; Mortality; Whole blood viscoelastic testing profile.