AMO – Academic Medical Organization of Southwestern Ontario
AMO-20-030 – Hypercoagulation in SARS-CoV-2 infection – Conventional Coagulation Testing versus Point of Care Thromboelastography
We have been successful in procuring and implementing a thromboelastography (TEG) platform at LHSC. The TEG equipment has arrived on site at University Hospital and we are in the final stages of education training before the platform will be ready for use. One of the key goals of this project was the implementation of an in-house TEG platform to support, not only COVID-19 patient care, but also to support the critically ill afflicted with other future emerging pathogens. The TEG technology will also support the Cardiac Surgery and Liver Transplantation service lines. Many other stakeholders including Trauma, Spine, Obstetrics/Gynecology, Hematology, Pathology and Laboratory Medicine, Hepatology/Gastroenterology, and Complex Coagulation services will also leverage this technology. Thus, this newly established testing platform will provide hospital-wide benefits to improve patient care. While awaiting the arrival of the TEG equipment, our team successfully completed the recruitment of our target 30 critically ill COVID-19 infected patients. During their time in hospital, all COVID-19 patients had conventional coagulation testing performed as standard of care. At this time, we also collected matched blood samples, which have been carefully prepared and stored. These patient blood samples will soon be analyzed via TEG and we will compare the measurement and detection of hypercoagulation markers between TEG and standard of care CCT testing at matched time points. We expect that TEG testing results will allow us to observe increased maximum clot strength, and shorter kinetics of clot development typical of hypercoagulation in COVID-19 patients admitted to the ICU. Furthermore, we expect to identify the hypercoagulation earlier than it is detectable using CCT and more precisely. We anticipate that the occurrence of these markers of hypercoagulation will correlate with an increased incidence in secondary outcomes, including thrombotic events (pulmonary embolism, deep venous thrombosis, stroke, arterial embolism, and intracardiac thrombosis), bleeding, organ failure, superinfection, and mortality. Once we have the TEG analysis results we will begin these comparisons to determine if TEG will identify hypercoagulability earlier and more precisely such that patients can be considered for targeted therapeutic interventions, such as anticoagulation, capable of preventing blood clots and their serious complications.
Prevention and Treatment
Primary Project Lead for Contact
Dr. Anton Skaro
Secondary Project Lead for Contact
Dr. Mayur Brahmania