Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory.
Identifieur interne : 000B43 ( Main/Exploration ); précédent : 000B42; suivant : 000B44Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory.
Auteurs : M. Hardy [Belgique] ; T. Lecompte ; J. Douxfils [Belgique] ; S. Lessire [Belgique] ; J M Dogné [Belgique] ; B. Chatelain [Belgique] ; S. Testa [Italie] ; I. Gouin-Thibault [France] ; Y. Gruel [France] ; R L Medcalf ; H. Ten Cate [Pays-Bas] ; G. Lippi [Italie] ; F. Mullier [Belgique]Source :
- Thrombosis journal [ 1477-9560 ] ; 2020.
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.
DOI: 10.1186/s12959-020-00230-1
PubMed: 32922211
PubMed Central: PMC7474970
Affiliations:
- Belgique, France, Italie, Pays-Bas
- Centre-Val de Loire, Province du Brabant wallon, Région Bretagne, Région Centre, Région wallonne
- Louvain-la-Neuve, Rennes, Tours
- Université catholique de Louvain
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Ten Cate</name><affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Lippi, G" sort="Lippi, G" uniqKey="Lippi G" first="G" last="Lippi">G. 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Hardy</name><affiliation wicri:level="4"><nlm:affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir</wicri:regionArea><orgName type="university">Université catholique de Louvain</orgName><placeName><settlement type="city">Louvain-la-Neuve</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province du Brabant wallon</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir</wicri:regionArea><orgName type="university">Université catholique de Louvain</orgName><placeName><settlement type="city">Louvain-la-Neuve</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province du Brabant wallon</region></placeName></affiliation></author><author><name sortKey="Lecompte, T" sort="Lecompte, T" uniqKey="Lecompte T" first="T" last="Lecompte">T. Lecompte</name><affiliation><nlm:affiliation>Département de Médecine, Hôpitaux Universitaires de Genève, service d'angiologie et d'hémostase et Faculté de Médecine Geneva Platelet Group (GpG), Université de Genève, Geneva, Suisse Switzerland.</nlm:affiliation><wicri:noCountry code="subField">Suisse Switzerland</wicri:noCountry></affiliation></author><author><name sortKey="Douxfils, J" sort="Douxfils, J" uniqKey="Douxfils J" first="J" last="Douxfils">J. Douxfils</name><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur</wicri:regionArea><wicri:noRegion>Namur</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Qualiblood s.a, Namur, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Qualiblood s.a, Namur</wicri:regionArea><wicri:noRegion>Namur</wicri:noRegion></affiliation></author><author><name sortKey="Lessire, S" sort="Lessire, S" uniqKey="Lessire S" first="S" last="Lessire">S. Lessire</name><affiliation wicri:level="4"><nlm:affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir</wicri:regionArea><orgName type="university">Université catholique de Louvain</orgName><placeName><settlement type="city">Louvain-la-Neuve</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province du Brabant wallon</region></placeName></affiliation></author><author><name sortKey="Dogne, J M" sort="Dogne, J M" uniqKey="Dogne J" first="J M" last="Dogné">J M Dogné</name><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur</wicri:regionArea><wicri:noRegion>Namur</wicri:noRegion></affiliation></author><author><name sortKey="Chatelain, B" sort="Chatelain, B" uniqKey="Chatelain B" first="B" last="Chatelain">B. Chatelain</name><affiliation wicri:level="4"><nlm:affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir</wicri:regionArea><orgName type="university">Université catholique de Louvain</orgName><placeName><settlement type="city">Louvain-la-Neuve</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province du Brabant wallon</region></placeName></affiliation></author><author><name sortKey="Testa, S" sort="Testa, S" uniqKey="Testa S" first="S" last="Testa">S. Testa</name><affiliation wicri:level="1"><nlm:affiliation>Haemostasis and Thrombosis Center, Cremona Hospital, Cremona, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Haemostasis and Thrombosis Center, Cremona Hospital, Cremona</wicri:regionArea><wicri:noRegion>Cremona</wicri:noRegion></affiliation></author><author><name sortKey="Gouin Thibault, I" sort="Gouin Thibault, I" uniqKey="Gouin Thibault I" first="I" last="Gouin-Thibault">I. Gouin-Thibault</name><affiliation wicri:level="3"><nlm:affiliation>Département d'Hématologie Biologique, INSERM, CIC 1414 (Centre d'Investigation Clinique de Rennes), Université de Rennes, CHU de Rennes, Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Département d'Hématologie Biologique, INSERM, CIC 1414 (Centre d'Investigation Clinique de Rennes), Université de Rennes, CHU de Rennes, Rennes</wicri:regionArea><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Gruel, Y" sort="Gruel, Y" uniqKey="Gruel Y" first="Y" last="Gruel">Y. Gruel</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire d'Hématologie-Hémostase, CHRU de Tours, Hôpital Trousseau, Tours, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire d'Hématologie-Hémostase, CHRU de Tours, Hôpital Trousseau, Tours</wicri:regionArea><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Medcalf, R L" sort="Medcalf, R L" uniqKey="Medcalf R" first="R L" last="Medcalf">R L Medcalf</name><affiliation><nlm:affiliation>Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria Australia.</nlm:affiliation><wicri:noCountry code="subField">Victoria Australia</wicri:noCountry></affiliation></author><author><name sortKey="Ten Cate, H" sort="Ten Cate, H" uniqKey="Ten Cate H" first="H" last="Ten Cate">H. Ten Cate</name><affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Lippi, G" sort="Lippi, G" uniqKey="Lippi G" first="G" last="Lippi">G. Lippi</name><affiliation wicri:level="1"><nlm:affiliation>Section of Clinical Biochemistry, University of Verona, Verona, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Section of Clinical Biochemistry, University of Verona, Verona</wicri:regionArea><wicri:noRegion>Verona</wicri:noRegion></affiliation></author><author><name sortKey="Mullier, F" sort="Mullier, F" uniqKey="Mullier F" first="F" last="Mullier">F. Mullier</name><affiliation wicri:level="4"><nlm:affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir</wicri:regionArea><orgName type="university">Université catholique de Louvain</orgName><placeName><settlement type="city">Louvain-la-Neuve</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province du Brabant wallon</region></placeName></affiliation></author></analytic><series><title level="j">Thrombosis journal</title><idno type="ISSN">1477-9560</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32922211</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>16</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1477-9560</ISSN><JournalIssue CitedMedium="Print"><Volume>18</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Thrombosis journal</Title><ISOAbbreviation>Thromb J</ISOAbbreviation></Journal><ArticleTitle>Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory.</ArticleTitle><Pagination><MedlinePgn>17</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12959-020-00230-1</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>© The Author(s) 2020.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hardy</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</Affiliation><Identifier Source="GRID">grid.7942.8</Identifier><Identifier Source="ISNI">0000 0001 2294 713X</Identifier></AffiliationInfo><AffiliationInfo><Affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium.</Affiliation><Identifier Source="GRID">grid.7942.8</Identifier><Identifier Source="ISNI">0000 0001 2294 713X</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lecompte</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Département de Médecine, Hôpitaux Universitaires de Genève, service d'angiologie et d'hémostase et Faculté de Médecine Geneva Platelet Group (GpG), Université de Genève, Geneva, Suisse Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Douxfils</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium.</Affiliation><Identifier Source="GRID">grid.6520.1</Identifier><Identifier Source="ISNI">0000 0001 2242 8479</Identifier></AffiliationInfo><AffiliationInfo><Affiliation>Qualiblood s.a, Namur, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lessire</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Anesthesiology Department, Yvoir, Belgium.</Affiliation><Identifier Source="GRID">grid.7942.8</Identifier><Identifier Source="ISNI">0000 0001 2294 713X</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dogné</LastName><ForeName>J M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Pharmacy Department, University of Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur, Belgium.</Affiliation><Identifier Source="GRID">grid.6520.1</Identifier><Identifier Source="ISNI">0000 0001 2242 8479</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chatelain</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</Affiliation><Identifier Source="GRID">grid.7942.8</Identifier><Identifier Source="ISNI">0000 0001 2294 713X</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Testa</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Haemostasis and Thrombosis Center, Cremona Hospital, Cremona, Italy.</Affiliation><Identifier Source="GRID">grid.419450.d</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gouin-Thibault</LastName><ForeName>I</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Département d'Hématologie Biologique, INSERM, CIC 1414 (Centre d'Investigation Clinique de Rennes), Université de Rennes, CHU de Rennes, Rennes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gruel</LastName><ForeName>Y</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Laboratoire d'Hématologie-Hémostase, CHRU de Tours, Hôpital Trousseau, Tours, France.</Affiliation><Identifier Source="GRID">grid.411167.4</Identifier><Identifier Source="ISNI">0000 0004 1765 1600</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Medcalf</LastName><ForeName>R L</ForeName><Initials>RL</Initials><AffiliationInfo><Affiliation>Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria Australia.</Affiliation><Identifier Source="GRID">grid.1002.3</Identifier><Identifier Source="ISNI">0000 0004 1936 7857</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ten Cate</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine, Cardiovascular Research Institute (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lippi</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Section of Clinical Biochemistry, University of Verona, Verona, Italy.</Affiliation><Identifier Source="GRID">grid.5611.3</Identifier><Identifier Source="ISNI">0000 0004 1763 1124</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mullier</LastName><ForeName>F</ForeName><Initials>F</Initials><Identifier Source="ORCID">0000-0001-6947-6099</Identifier><AffiliationInfo><Affiliation>Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Hematology Laboratory, Yvoir, Belgium.</Affiliation><Identifier Source="GRID">grid.7942.8</Identifier><Identifier Source="ISNI">0000 0001 2294 713X</Identifier></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Thromb J</MedlineTA><NlmUniqueID>101170542</NlmUniqueID><ISSNLinking>1477-9560</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Anticoagulation</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Coagulopathy</Keyword><Keyword MajorTopicYN="N">D-dimers</Keyword><Keyword MajorTopicYN="N">Fibrinolysis</Keyword><Keyword MajorTopicYN="N">Hemostasis</Keyword><Keyword MajorTopicYN="N">Heparin</Keyword><Keyword MajorTopicYN="N">Thrombin generation</Keyword><Keyword MajorTopicYN="N">Thrombosis</Keyword><Keyword MajorTopicYN="N">Viscoelastic tests</Keyword></KeywordList><CoiStatement>Competing interestsThe authors declare no competing interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>14</Day><Hour>5</Hour><Minute>49</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>15</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32922211</ArticleId><ArticleId IdType="doi">10.1186/s12959-020-00230-1</ArticleId><ArticleId IdType="pii">230</ArticleId><ArticleId IdType="pmc">PMC7474970</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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