Introduction/Aim. During the SARS-CoV-2 pandemic, there was a significant number of cases accompanied by thrombosis. The precise pathophysiological mechanism remains unclear. The importance of the fibrinolytic mechanism in maintaining physiological hemostasis led us to explore its potential contribution to COVID-19-induced thromboembolism. This study aimed to identify changes in the hemostasis at the time of admission of SARS-CoV-2-positive patients to the hospital and their influence on the disease outcome.
Methods. The presented prospective study included 60, rt-PCR-confirmed patients hospitalized in the Covid units of the Clinical Center of Vojvodina. Platelet number, platelet aggregability, aPTT, PT, fibrinogen, D-dimer, and Euglobulin Clot Lysis Time (ECLT) were determined from blood samples. Participants were classified as those with preserved and suppressed primary hemostasis, those with physiological and increased thrombin activity, those with preserved and decreased fibrinolytic activity, and those with positive and negative disease outcomes.
Results. Forty-four positive outcomes were observed (73.3%), while a negative outcome, including thromboembolic complications and death was present in 16 subjects (26.7%). Unconditional logistic regression revealed a mild negative influence of all investigated parameters on the disease outcome. For ECLT, OR was 1.084 with 95%CI 1.023 – 1.160. The multivariate regression model showed that of all the investigated parameters, only ECLT was a significant predictor for negative outcome with a level of p < 0.001.
Conclusion. The global assessment of the fibrinolytic mechanism is a useful predictor of disease outcome in SARS-CoV-2-positive patients at the moment of their admission to hospital.

 Keywords: SARS-CoV-2, Covid-19, hemostasis, fibrinolysis

 

Corresponding author:
Dejan Dobrijević
e-mail: dejan.dobrijevic@mf.uns.ac.rs