Evidence map›Paper›PMID 37267317›Full record

ArticlePloS one2023

Integral assays of hemostasis in hospitalized patients with COVID-19 on admission and during heparin thromboprophylaxis.

Andrey Y Bulanov, Ekaterina L Bulanova, Irina B Simarova, Elizaveta A Bovt, Olesya O Eliseeva, Soslan S Shakhidzhanov, Mikhail A Panteleev, Aleksandr G Roumiantsev, Fazoil I Ataullakhanov, Sergey S Karamzin

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Andrey Y BulanovMoscow City Clinical Hospital №52 of Healthcare Department, Moscow, Russia.
Ekaterina L BulanovaMoscow City Clinical Hospital №52 of Healthcare Department, Moscow, Russia.
Irina B SimarovaMoscow City Clinical Hospital №52 of Healthcare Department, Moscow, Russia.
Elizaveta A BovtDmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.ORCID 0000-0003-4724-8647
Olesya O EliseevaFaculty of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia.
Soslan S ShakhidzhanovDmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
Mikhail A PanteleevDmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
Aleksandr G RoumiantsevDmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
Fazoil I AtaullakhanovDmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
Sergey S KaramzinCenter for Theoretical Problems of Physicochemical Pharmacology, Moscow, Russia.
Center for Theoretical Problems of Physicochemical Pharmacology · RUCity Clinical Hospital · RUMoscow Institute of Physics and Technology · RUDmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood coagulation abnormalities play a major role in COVID-19 pathophysiology. However, the specific details of hypercoagulation and anticoagulation treatment require investigation. The aim of this study was to investigate the status of the coagulation system by means of integral and local clotting assays in COVID-19 patients on admission to the hospital and in hospitalized COVID-19 patients receiving heparin thromboprophylaxis.

methodsThrombodynamics (TD), thromboelastography (TEG), and standard clotting assays were performed in 153 COVID-19 patients observed in a hospital setting. All patients receiving treatment, except extracorporeal membrane oxygenation (ECMO) patients (n = 108), were administered therapeutic doses of low molecular weight heparin (LMWH) depending on body weight. The ECMO patients (n = 15) were administered unfractionated heparin (UFH).

resultsOn admission, the patients (n = 30) had extreme hypercoagulation by all integral assays: TD showed hypercoagulation in ~75% of patients, while TEG showed hypercoagulation in ~50% of patients. The patients receiving treatment showed a significant heparin response based on TD; 77% of measurements were in the hypocoagulation range, 15% were normal, and 8% remained in hypercoagulation. TEG showed less of a response to heparin: 24% of measurements were in the hypocoagulation range, 59% were normal and 17% remained in hypercoagulation. While hypocoagulation is likely due to heparin treatment, remaining in significant hypercoagulation may indicate insufficient anticoagulation for some patients, which is in agreement with our clinical findings. There were 3 study patients with registered thrombosis episodes, and all were outside the target range for TD parameters typical for effective thromboprophylaxis (1 patient was in weak hypocoagulation, atypical for the LMWH dose used, and 2 patients remained in the hypercoagulation range despite therapeutic LMWH doses).

conclusionPatients with COVID-19 have severe hypercoagulation, which persists in some patients receiving anticoagulation treatment, while significant hypocoagulation is observed in others. The data suggest critical issues of hemostasis balance in these patients and indicate the potential importance of integral assays in its control.

Indexed as

COVID-19ThrombophiliaVenous ThromboembolismAnticoagulantsHemostasisHeparinHeparin, Low-Molecular-WeightHumansAnticoagulantsHeparinHeparin, Low-Molecular-Weight

Identifiers

PMID37267317
PMCPMC10237390
OpenAlexW4379117757

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.