Thromboelastographic method for early decision on anticoagulant therapy in moderate to severe COVID-19 patients

  • Komang Ayu Ferdiana Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-7163-8958
  • Andi Ade Wijaya Ramlan Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Ratna Farida Soenarto Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Anas Alatas Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
DOI: https://doi.org/10.13181/mji.oa.225890
Keywords: blood coagulation disorder, COVID-19, intensive care unit, mortality, thromboelastography
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Abstract

BACKGROUND Coagulopathy is a serious COVID-19 complication that requires rapid diagnosis and anticoagulation. This study aimed to determine the role of coagulation examination using thromboelastography (TEG) on the decision-making time of anticoagulant therapy in COVID-19 patients and its clinical outcomes.

METHODS A prospective observational study was conducted in Cipto Mangunkusumo Hospital, Indonesia, from October 2020 to March 2021. We consecutively recruited moderate and severe COVID-19 patients in the high and intensive care units. Turnaround time, time to anticoagulant therapy decision, and clinical outcomes (length of stay and 30-day mortality) were compared between those who had a TEG examination in addition to the standard coagulation profile examination (thrombocyte count, PT, APTT, D-dimer, and fibrinogen) and those who had only a standard coagulation profile laboratory examination.

RESULTS Among 100 moderate to severe COVID-19 patients recruited, 50 patients had a TEG examination. The turnaround time of TEG was 45 (15–102) min versus 82 (19–164) min in the standard examination (p<0.001). The time to decision was significantly faster in the TEG group than the standard group (75 [42–133] min versus 184 [92–353] min, p<0.001). The turnaround time was positively correlated with time to decision (r = 0.760, p<0.001). However, TEG did not improve clinical outcomes such as length of stay (10.5 [3–20] versus 9 [2–39] days) and 30-day mortality (66% versus 64%).

CONCLUSIONS The TEG method significantly enables quicker decision-making time for moderate to severe coagulation disorder in COVID-19 patients.

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Published
2022-07-14
How to Cite
1.
Ferdiana KA, Ramlan AAW, Soenarto RF, Alatas A. Thromboelastographic method for early decision on anticoagulant therapy in moderate to severe COVID-19 patients. Med J Indones [Internet]. 2022Jul.14 [cited 2024Apr.20];31(2):96-101. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/5890
Issue
Vol. 31 No. 2 (2022): June
Section
Clinical Research

Copyright (c) 2022 Komang Ayu Ferdiana, Andi Ade Wijaya Ramlan, Ratna Farida Soenarto, Anas Alatas

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