Thromboelastography in COVID-19 patients: An observational study in the South African context

African Journal of Laboratory Medicine

 
 
Field Value
 
Title Thromboelastography in COVID-19 patients: An observational study in the South African context
 
Creator Pillay, Bavinash van Blydenstein, Sarah A. Omar, Shahed
 
Subject Internal Medicine; Laboratory Medicine; Haematology; Pulmonology; Critical Care; Thrombosis thromboelastogram; low molecular weight heparin; heparin; coronavirus disease 2019; viscoelastic methods; coagulopathy.
Description Background: Coronavirus disease 2019 (COVID-19) increases the risk of venous thromboembolism, requiring monitoring of low molecular weight heparin (LMWH) via a time-consuming, costly and often unavailable test – anti-factor Xa (anti-Xa). An affordable, rapid point-of-care alternative, the thromboelastogram, is available, but performance comparisons to anti-Xa are lacking.Objective: This study evaluated the relationship between anti-Xa and thromboelastogram in patients with COVID-19 receiving LMWH.Methods: This was a retrospective study of patients with COVID-19 receiving LMWH at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, between November 2020 and January 2021. Blood samples tested with thromboelastogram and anti-Xa were drawn at three timepoints (one prior to and two after administration of LMWH). Thromboelastogram parameters comprised reaction time (R-time; onset of testing to the start of clot formation), kinetics time (K-time; start of clot formation until the clot reached 20 mm), and thromboelastogram coagulation index (overall coagulation status of whole blood).Results: Forty-two patients with COVID-19 (15 male and 27 female) met the study criteria. There was a statistically significant, low to moderate correlation (Spearman’s correlation coefficient [rs 0.43, p = 0.014]) between anti-Xa and thromboelastogram coagulation index. A statistically significant moderate correlation (rs 0.52, p = 0.002) between anti-Xa and R-time, and a statistically significant low correlation (rs 0.35, p = 0.049) between anti-Xa and K-time, were found. All correlations were 48 h post admission.Conclusion: Thromboelastogram coagulation index, R-times and K-times had a statistically significant association with anti-Xa levels in patients with COVID-19. Further research is required regarding their clinical utility.What this study adds: Thromboelastograms may represent a more cost-effective and accessible option to the conventional anti-Xa test in patients receiving LMWH. However, future research with larger sample sizes, varying disease profiles, and severity of illness is required.
 
Publisher AOSIS
 
Contributor Nil
Date 2025-06-26
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Observational study
Format text/html application/epub+zip text/xml application/pdf application/pdf
Identifier 10.4102/ajlm.v14i1.2681
 
Source African Journal of Laboratory Medicine; Vol 14, No 1 (2025); 8 pages 2225-2010 2225-2002
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://ajlmonline.org/index.php/ajlm/article/view/2681/3172 https://ajlmonline.org/index.php/ajlm/article/view/2681/3173 https://ajlmonline.org/index.php/ajlm/article/view/2681/3174 https://ajlmonline.org/index.php/ajlm/article/view/2681/3176 https://ajlmonline.org/index.php/ajlm/article/view/2681/3175
 
Coverage Johannesburg, Gauteng, South Africa — Age 18 years and older, any gender, any ethnicity.
Rights Copyright (c) 2025 Bavinash Pillay, Sarah A. van Blydenstein, Shahed Omar https://creativecommons.org/licenses/by/4.0
ADVERTISEMENT