Association between Thrombin Generation and Clinical Characteristics in COVID-19 Patients

Omri Cohen, Nitsan Landau, Einat Avisahai, Tami Brutman-Barazani, Ivan Budnik, Tami Livnat, Keren Asraf, Ram Doolman, Sarina Levy-Mendelovich, Orly Efros, Uri Manor, Eyal Meltzer, Gad Segal, Galia Rahav, Gili Kenet

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1 Scopus citations


Introduction: Coronavirus disease 2019 (COVID-19) disease is associated with coagulopathy and an increased risk of thrombosis. An association between thrombin generation (TG) capacity, disease severity, and outcomes has not been well described. Methods: We assessed the correlation of TG with sequential organ failure assessment (SOFA) and sepsis-induced coagulopathy (SIC) scores and clinical outcomes by analysis of plasma samples obtained from hospitalized COVID-19 patients. Results: 32 patients (68.8% male), whose median age was 69 years, were assessed, of whom only 3 patients did not receive anticoagulant therapy. D-dimers were uniformly increased. During hospitalization, 2 patients suffered thrombosis, 3 experienced bleeding, and 12 died. TG parameters from anticoagulated COVID-19 patients did not significantly differ from the values obtained from non-anticoagulated healthy controls. Patients who received higher than prophylactic doses of anticoagulant therapy had increased lag time (p = 0.003), lower endogenous thrombin potential (ETP) (p = 0.037), and a reduced peak height (p = 0.006). ETP correlated with the SIC score (p = 0.038). None of the TG parameters correlated with the SOFA score or were associated with mortality. Conclusion: TG was not associated with disease severity among patients hospitalized with COVID-19. However, a correlation between ETP and the SIC score was noted and deserves attention.

Original languageEnglish
Pages (from-to)151-160
Number of pages10
JournalActa Haematologica
Issue number2
StatePublished - 1 Mar 2023


FundersFunder number


    • Anticoagulation
    • Bleeding
    • COVID-19
    • SOFA
    • Sepsis-induced coagulopathy
    • Thrombin generation
    • Thrombosis


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