Thrombin generation in patients with COVID-19 with and without thromboprophylaxis

Abstract Objectives Thrombin generation (TG) with and without thrombomodulin (TM) was evaluated in COVID-19 patients different disease severity thromboprophylaxis regimen, order to understand the prothrombotic profile. Methods We enrolled consecutive confirmed diagnosis of admitted Medical Departments (MD) or Intensive Care Units (ICU), 54 healthy controls. Results Eighty-nine were included (mean age 60.4±16.1 years, 68.5% male); 33.7% ICU. Twenty-four (26.9%) before administration; 45 (50.6%) received standard 20 (22.5%) intermediate sub-therapeutic dose thromboprophylaxis. Overall, showed a TG profile comparable that subjects (i.e. peak height, endogenous thrombin potential [ETP] TM). The only exception lag time peak, prolonged vs. MD similar controls, ICU significantly decrease ETP (p=0.030) compared MD. As for thromboprophylaxis, increased controls those In this latter group, inhibition decreased (p=0.0003) positively correlated anti-Xa activity (r=0.49, p=0.0017). However, had Intermediate more effectively inhibited severe by increasing via TM reduction dose. Conclusions at diagnosis. Standard reduced levels decreasing TM.