{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:24:33Z","timestamp":1761578673212,"version":"3.41.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Standard biomarkers have been widely used for COVID-19 diagnosis and prognosis. We hypothesize that thrombogenicity metrics measured by thromboelastography will provide better diagnostic and prognostic utility versus standard biomarkers in COVID-19 positive patients. In this observational prospective study, we included 119 hospitalized COVID-19 positive patients and 15 COVID-19 negative patients. On admission, we measured standard biomarkers and thrombogenicity using a novel thromboelastography assay (TEG-6s). In-hospital all-cause death and thrombotic occurrences (thromboembolism, myocardial infarction and stroke) were recorded. Most COVID-19 patients were African--Americans (68%). COVID-19 patients versus COVID-19 negative patients had higher platelet-fibrin clot strength (P-FCS), fibrin clot strength (FCS) and functional fibrinogen level (FLEV) (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a\u2264\u200a0.003 for all). The presence of high TEG-6\u200as metrics better discriminated COVID-19 positive from negative patients. COVID-19 positive patients with sequential organ failure assessment (SOFA) score at least 3 had higher P-FCS, FCS and FLEV than patients with scores less than 3 (<jats:italic toggle=\"yes\">P<\/jats:italic>\u200a\u2264\u200a0.001 for all comparisons). By multivariate analysis, the in-hospital composite endpoint occurrence of death and thrombotic events was independently associated with SOFA score more than 3 [odds ratio (OR)\u200a=\u200a2.9, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a=\u200a0.03], diabetes (OR\u200a=\u200a3.3, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a=\u200a0.02) and FCS\u200a&gt;\u200a40\u200amm (OR\u200a=\u200a3.4, <jats:italic toggle=\"yes\">P<\/jats:italic>\u200a=\u200a0.02).<\/jats:p>\n            <jats:p>This largest observational study suggested the early diagnostic and prognostic utility of thromboelastography to identify COVID-19 and should be considered hypothesis generating. Our results also support the recent FDA guidance regarding the importance of measurement of whole blood viscoelastic properties in COVID-19 patients. Our findings are consistent with the observation of higher hospitalization rates and poorer outcomes for African--Americans with COVID-19.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/mbc.0000000000001069","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T22:43:29Z","timestamp":1628549009000},"page":"544-549","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm?"],"prefix":"10.1097","volume":"32","author":[{"given":"Paul A.","family":"Gurbel","sequence":"first","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin P.","family":"Bliden","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerrold H.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naval","family":"Walia","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Rapista","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alastair","family":"Cho","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Jerjian","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Udaya S.","family":"Tantry","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Lifebridge Health, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"R1-20250617","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"R2-20250617","doi-asserted-by":"crossref","first-page":"e0238160","DOI":"10.1371\/journal.pone.0238160","article-title":"Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: a meta-analysis of 6320 patients","volume":"15","author":"Elshazli","year":"2020","journal-title":"PLoS One"},{"key":"R3-20250617","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/09537100802687666","article-title":"The link between heightened thrombogenicity and inflammation: preprocedure 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unit for acute respiratory failure","volume":"120","author":"Spiezia","year":"2020","journal-title":"Thromb Haemost"},{"key":"R10-20250617","first-page":"12466","article-title":"Thromboelastography clot strength profiles and effect of systemic anticoagulation in COVID-19 acute respiratory distress syndrome: a prospective, observational study","volume":"24","author":"Bocci","year":"2020","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"R11-20250617","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1007\/s11239-021-02435-1","article-title":"Bedside thromboelastography to rapidly assess the pharmacodynamic response of anticoagulants and aspirin in COVID-19: evidence of inadequate therapy in a predominantly minority population","volume":"51","author":"Gurbel","year":"2021","journal-title":"J Thromb Thrombolysis"},{"key":"R12-20250617","doi-asserted-by":"crossref","first-page":"642","DOI":"10.3109\/09537104.2016.1153617","article-title":"First report of the point-of-care TEG: a technical validation study of the TEG-6S system","volume":"27","author":"Gurbel","year":"2016","journal-title":"Platelets"},{"key":"R14-20250617","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12959-020-00230-1","article-title":"Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory","volume":"18","author":"Hardy","year":"2020","journal-title":"Thromb J"},{"key":"R15-20250617","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s11739-020-02601-y","article-title":"COVID-19 coagulopathy: is it disseminated intravascular coagulation?","volume":"16","author":"Levi","year":"2021","journal-title":"Intern Emerg Med"},{"key":"R16-20250617","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1161\/ATVBAHA.120.314514","article-title":"Coagulation abnormalities and thrombosis in patients infected with SARS-CoV-2 and other pandemic viruses","volume":"40","author":"Mackman","year":"2020","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"R17-20250617","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/jth.14810","article-title":"ISTH interim guidance on recognition and management of coagulopathy in COVID-19","volume":"18","author":"Thachil","year":"2020","journal-title":"J Thromb Haemost"},{"key":"R18-20250617","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1111\/jth.14939","article-title":"All those D-dimers in COVID-19","volume":"18","author":"Thachil","year":"2020","journal-title":"J Thromb Haemost"},{"key":"R19-20250617","doi-asserted-by":"crossref","first-page":"100647","DOI":"10.1016\/j.eclinm.2020.100647","article-title":"Race-related disparities in COVID-19 thrombotic outcomes: beyond social and economic explanations","volume":"29","author":"Chaudhary","year":"2020","journal-title":"EClinicalMedicine"}],"container-title":["Blood Coagulation &amp; 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