Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

M Hardy; T Lecompte; J Douxfils; S Lessire; J M Dogné; B Chatelain; S Testa; I Gouin-Thibault; Y Gruel; R L Medcalf; H Ten Cate; G Lippi; F Mullier

doi:10.1186/s12959-020-00230-1

Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

M Hardy, T Lecompte, J Douxfils, S Lessire, J M Dogné, B Chatelain, S Testa, I Gouin-Thibault, Y Gruel, R L Medcalf, H Ten Cate, G Lippi, F Mullier

Universite de Namur

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Résumé

Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

langue originale	Anglais
Numéro d'article	17
Pages (de - à)	17
journal	Thrombosis journal
Volume	18
Numéro de publication	1
Les DOIs	https://doi.org/10.1186/s12959-020-00230-1
Etat de la publication	Publié - 7 sept. 2020

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10.1186/s12959-020-00230-1

5223-2020-HardyVersion finale publiée, 831 KBLicense: CC BY

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The COVILAB project : Clinical laboratory investigations related to COVID-19
Douxfils, J. (Promoteur), Dogne, J.-M. (Co-Promoteur), FAVRESSE, J. (Co-investigateur), Tre-Hardy, M. (Co-investigateur), Mullier, F. (Co-investigateur), Haguet, H. (Chercheur), Hardy, M. (Chercheur), Melchionda, S. (Chercheur), BOUVY, C. (Chercheur), Morimont, L. (Chercheur), Gillot, C. (Chercheur), Djokoto, H. (Chercheur), Alpan, L. (Technicien), Devel, P. (Technicien), Modaffari, E. (Technicien) & Maloteau, V. (Technicien)
13/03/20 → …
Projet: Recherche

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Hardy, M., Lecompte, T., Douxfils, J., Lessire, S., Dogné, J. M., Chatelain, B., Testa, S., Gouin-Thibault, I., Gruel, Y., Medcalf, R. L., Ten Cate, H., Lippi, G., & Mullier, F. (2020). Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory. Thrombosis journal, 18(1), 17. Article 17. https://doi.org/10.1186/s12959-020-00230-1

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abstract = "Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.",

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AU - Gouin-Thibault, I

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N2 - Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

AB - Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

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KW - Viscoelastic tests

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Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

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The COVILAB project : Clinical laboratory investigations related to COVID-19

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