Blood Test May Predict Clot Risk in Severe COVID-19: JAMA
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Hypercoagulability on thromboelastography (TEG) was a good predictor of thrombotic events among COVID-19 patients entering the ICU, according to a single-center study published in JAMA Network. The clinically significant thrombosis that developed in 13 of 21 PCR-test-positive patients seen at Baylor St. Luke's Medical Center ICU was associated with hypercoagulable TEG parameters in all cases.

- Maximum amplitude on that test was elevated in all 10 patients with two or more thrombotic complications compared with 45% of those with no more than one such event (nearly all arterial, central venous, or dialysis catheter or filter thromboses).

- Other typical coagulation markers -- prothrombin time, INR, partial thromboplastin time, and platelet levels -- were not predictive between those two groups,

- Innate TEG maximum amplitude measured at entry to the ICU thus had 100% sensitivity and 100% negative predictive value (with 55% specificity) for patients who would go on to have multiple thrombotic complications.

- TEG is typically used to test for lack of coagulation factors in cases of trauma or open heart surgery patients who are bleeding. The group started using it to figure out why patients were having central lines and dialysis lines clog up with clots when most of their normal blood tests weren't picking up a problem.

- TEG wouldn't replace duplex ultrasonography or any other method to detect and diagnose deep vein thrombosis (DVT) and the other thrombotic manifestations seen with severe COVID-19, researchers noted.

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