Resumen

PILLAY, Bavinash; VAN BLYDENSTEIN, Sarah A.  y  OMAR, Shahed. Thromboelastography in COVID-19 patients: An observational study in the South African context. Afr. J. Lab. Med. [online]. 2025, vol.14, n.1, pp.1-8. ISSN 2225-2010.  https://doi.org/10.4102/ajlm.v14i1.2681.

BACKGROUND: Coronavirus disease 2019 (COVID-19) increases the risk of venous thromboembolism, requiring monitoring of low molecular weight heparin (LMWH) via a time-consuming, costly and often unavailable test - anti-factor Xa (anti-Xa). An affordable, rapid point-of-care alternative, the thromboelastogram, is available, but performance comparisons to anti-Xa are lacking OBJECTIVE: This study evaluated the relationship between anti-Xa and thromboelastogram in patients with COVID-19 receiving LMWH METHODS: This was a retrospective study of patients with COVID-19 receiving LMWH at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, between November 2020 and January 2021. Blood samples tested with thromboelastogram and anti-Xa were drawn at three timepoints (one prior to and two after administration of LMWH). Thromboelastogram parameters comprised reaction time (R-time; onset of testing to the start of clot formation), kinetics time (K-time; start of clot formation until the clot reached 20 mm), and thromboelastogram coagulation index (overall coagulation status of whole blood RESULTS: Forty-two patients with COVID-19 (15 male and 27 female) met the study criteria. There was a statistically significant, low to moderate correlation (Spearman's correlation coefficient [r_s 0.43, p = 0.014]) between anti-Xa and thromboelastogram coagulation index. A statistically significant moderate correlation (r_s 0.52, p = 0.002) between anti-Xa and R-time, and a statistically significant low correlation (r_s 0.35, p = 0.049) between anti-Xa and K-time, were found. All correlations were 48 h post admission CONCLUSION: Thromboelastogram coagulation index, R-times and K-times had a statistically significant association with anti-Xa levels in patients with COVID-19. Further research is required regarding their clinical utility WHAT THIS STUDY ADDS: Thromboelastograms may represent a more cost-effective and accessible option to the conventional anti-Xa test in patients receiving LMWH. However, future research with larger sample sizes, varying disease profiles, and severity of illness is required.

Palabras clave : thromboelastogram; low molecular weight heparin; heparin; coronavirus disease 2019; viscoelastic methods; coagulopathy.

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