Special test detects who’s at risk for life-threatening blood clots from COVID-19

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Coronavirus disease (COVID-19) can cause life-threatening blood clots but those at risk may not show up on the usual tests. Instead, doctors should use a more sensitive test that is usually used for trauma and open heart surgery, according to NHLBI-funded research published in JAMA Network Open.

Researchers at Baylor College of Medicine decided to investigate the clot issue after COVID-19 patients in the ICU unexpectedly developed clots. They looked at 21 patients with COVID-19 admitted to the Baylor St. Luke’s Medical Center ICU between March 15 and April 9. Initial tests showed that all the patients had a normal clotting profile. The researchers then used additional tests to look at their fibrinogen and D dimer levels, which can be an indication of clotting risk, but those were normal too.

The researchers then tried a more sensitive test called thromboelastography (TEG), which is more commonly used for trauma and open heart surgery and looks at how quickly a clot forms, its strength and stability. This test showed that the patients who were clotting had abnormally high clotting function and clot breakdown function compared with patients who weren’t having clotting problems. In total, 13 of the 21 patients had clots that could only be detected through the TEG test.

The researchers recommend that physicians use the TEG test on all COVID-19 patients in the ICU so they can identify those at high risk of clotting problems and treat them with anti-clotting medication before they occur.