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Abstract
In Coronavirus disease 2019 (COVID-19) subjects, recent evidence suggests the presence of unique coagulation abnormalities. In this study, we performed clot waveform analyses to investigate whether specific modulations are observed in COVID-19 subjects. We analyzed the second derivative of the absorbance in routine APTT tests performed using an ACL-TOP system. We observed high frequencies of abnormal patterns in APTT second-derivative curves that could be classified into an early shoulder type, a late shoulder type, or a biphasic type, high maximum first-derivative and second-derivative peak levels, and a low minimum second-derivative peak level in COVID-19 subjects. These modulations were not observed in subjects with disseminated intravascular coagulation. These abnormal patterns are also observed in patients with lupus anticoagulant, hemophilia, or factor IX deficiency. The plasma fibrinogen levels might also be involved in the abnormal APTT waveforms, especially the high maximum first-derivative and second-derivative peak levels. The abnormal patterns in the APTT second-derivative curves appear with highest frequency at around 2 weeks after the onset of COVID-19 and were not associated with the severity of COVID-19. These results suggest the possible presence of a specific abnormal coagulopathy in COVID-19.
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Details
1 The University of Tokyo, Department of Clinical Laboratory Medicine, Graduate School of Medicine, Tokyo, Japan (GRID:grid.26999.3d) (ISNI:0000 0001 2151 536X)
2 The University of Tokyo Hospital, Department of Infectious Diseases, Tokyo, Japan (GRID:grid.412708.8) (ISNI:0000 0004 1764 7572)
3 The University of Tokyo Hospital, Department of Infectious Diseases, Tokyo, Japan (GRID:grid.412708.8) (ISNI:0000 0004 1764 7572); The University of Tokyo Hospital, Department of Infection Control and Prevention, Tokyo, Japan (GRID:grid.412708.8) (ISNI:0000 0004 1764 7572)
4 The University of Tokyo Hospital, Department of Infection Control and Prevention, Tokyo, Japan (GRID:grid.412708.8) (ISNI:0000 0004 1764 7572)