1.Thromboelastography Parameter and Its Association with Survival of COVID-19 Patients: A Retrospective Cross-Sectional Study
Nita Wiyono ; Yetti Hernaningsih ; Arifoel Hajat ; Paulus Budiono Notopuro ; Narazah Mohd Yusoff ; Emmanuel Jairaj Moses
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):124-129
Introduction: Coagulopathy associated with Coronavirus disease 2019 (COVID-19) may cause life-threatening complications, especially in severe or critically ill COVID-19 patients. Thromboelastography (TEG) is an effective, dynamic, and reliable test to assess the complete coagulation process. This study aimed to determine the association
between selected TEG parameters and survival in COVID-19 patients. Methods: This study was a retrospective
observational study using data from medical records of COVID-19 patients who were hospitalized in Dr. Soetomo
Hospital, Surabaya, Indonesia. There were 94 COVID-19 patients consisting of 76 survivors and 18 non-survivors.
The association between TEG results and certain TEG parameters with survival status was considered significant if
the p-value ≤ 0.05. Results: Increased coagulation activity had a significant association with the survival status of
COVID-19 patients (p=0.04). There were no significant differences in all TEG parameters between COVID-19 patients who survived and those who did not survive (p > 0.05). Based on the TEG analysis tree, the most TEG results
found were secondary fibrinolysis (21.3%) and fibrinolytic shutdown (24.5%). No significant association was found
between the coagulability and fibrinolysis abnormality with the survival status in COVID-19 patients (p > 0.05).
Conclusion: There was no significant difference in TEG results between COVID-19 survivors and non-survivors.
However, based on the TEG result, an increase in coagulation activity is associated with a lower survival rate. Further study with detailed timing of TEG examination, disease severity and comorbidities stratification in COVID-19
patients may be needed.