Presentation Details
| Coagulation profile and clot stiffness analysis from COVID-19-positive patients using a novel viscoelasticity testing technology Dimitria Bonizol Camasao1, 2+, Jose G.Munguia-Lopez1+, Anna Perez5, José A.Correa3, Cedric Schmitt2, Anis Hadj Henni2, Chantal Séguin4, Donald C.Vinh5, Showan N.Nazhat1*. 1Department of Mining and Materials Engineering, McGill University, Montreal, QC, Canada.2Rheolution Inc., Montreal, QC, Canada.3Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.4Department of Medicine, Division of Hematology, McGill University Health Centre, McGill University, Montreal, QC, Canada.5Department of Experimental Medicine, Division of Infectious Diseases, McGill University Health Centre, McGill University, Montreal, QC, Canada |
Abstract
Background COVID-19-associated coagulopathy represents a serious complication from the SARS-CoV-2 infection that can lead to thromboembolic events. A personalized patient-oriented treatment is sought given the large diversity of patient cohorts, with the analysis of different biomarkers and coagulation profiles. The viscoelasticity testing of bilayered materials (VeTBiM) technology has been recently introduced as a precise method to measure the real-time viscoelasticity of coagulating blood. In this work, this technology was used to obtain the coagulation profile and the clot stiffness of plasma samples from hospitalized patients in the general COVID-19 ward (non-ICU) and in the intensive care unit (ICU). Methods Eighteen plasma samples from eleven hospitalized patients, collected at various times relative to the first positive SARS-CoV-2 PCR result (Dec 2020 - Jun 2021), were obtained from the McGill University Health Centre COVID-19 Biobank (Montreal, Canada). Activated partial thromboplastin time reagents (Thermo Fisher Scientific) induced the coagulation of plasma samples. The final solution was immediately tested in the ElastoSensTM Bio (VeTBiM technology, Rheolution, Canada) at 37 °C (figure 1). Shear storage modulus (G’ in Pascals [Pa], physical property that represents the stiffness of the forming clot) as a function of time was obtained for each sample. Four descriptors were extracted from the G’-vs-time curves: clotting initiation time (time at which G’ reached 15 Pa), clotting time (time at which G’ reached 90% of final G’), maximum clotting rate (Pa/s) and final clot stiffness (final G’). Multiple linear regression analyses were performed to examine the effects of ICU admission, sampling time, among others, on these descriptors. Results Figure 2 displays the four descriptors extracted from the coagulation profiles. Clotting initiation time did not show a trend over time with values ranging from 20 to 120 s. Clotting time slightly decreased over time, in line with a slight increase in the maximum clotting rate. This tendency implies that clotting occurs more rapidly as time advances from the onset of the disease, however, a larger number of samples especially from each individual should be analyzed to confirm this trend. Clot stiffness underwent a significant decrease over time. For this descriptor only, statistical analysis showed an interaction effect between ICU admission (i.e., non-ICU vs ICU) and blood sampling time (p<0.0001). In the presence of other covariates, the results showed a more rapid decrease in the clot stiffness for the non-ICU patients compared to those in the ICU. Previous studies suggest that clot stiffness is directly related to the occurrence of thromboembolic complications, and therefore the monitoring of this parameter could help in optimizing anticoagulant therapies. Conclusions The VeTBiM technology has demonstrated potential in providing precise information on the coagulation profile and clot stiffness from plasma samples. The clot stiffness decreased with time post COVID-19 infection, and at a slower rate for patients in the ICU when compared to those in the general ward. This type of analysis can be valuable in research for the fundamental study of coagulopathies as well as in clinics to help establish personalized and more effective treatments for this life-threatening complication.
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