A high risk of thrombotic complications has been observed among severely ill COVID-19 patients. Viscoelastic tests (VET) have shown a hypercoagulable profile in these patients, although so far there is no clear evidence on the use of these tools as predictors of risk in the clinical course of patients. In this study we aimed to evaluate the association between Quantra® sonorheometry VET parameters, standard coagulation tests and inflammatory markers in 69 patients with COVID-19 on hospital admission with disease severity and outcome. Inflammatory markers were elevated in a high percentage of patients, as were coagulation-related parameters such as fibrinogen and D-dimer levels. Quantra® sonorheometry analysis revealed increased clot stiffness (CS), especially due to increased fibrinogen contribution (FCS) in 63.7%. Analysis of clot stability to lysis (CSL) on the Quantra showed a value of 100%, suggesting hypofibrinolysis, in 32.4%. Age > 65 years, elevated values of fibrinogen, D-dimer, LDH, increased CS and CSL were significantly associated with worsening disease. The combination of elevated FCS and D-dimer values showed a particularly high prognostic value in distinguishing patients with severe symptomatology. In conclusion, FCS measured by Quantra® system and its combination with D-dimer could be established as a powerful tool to identify poor prognosis in COVID-19 patients on hospital admission.

在重症 COVID-19 患者中观察到血栓并发症的风险很高。粘弹性测试（VET）显示这些患者存在高凝状态，尽管到目前为止还没有明确的证据表明使用这些工具作为患者临床过程中风险的预测因子。在本研究中，我们旨在评估 69 名入院的 COVID-19 患者的 Quantra® 声测速 VET 参数、标准凝血测试和炎症标志物与疾病严重程度和结果之间的关联。大部分患者的炎症标志物升高，凝血相关参数（如纤维蛋白原和 D-二聚体水平）也升高。 Quantra® 声流变测量分析显示血栓硬度 (CS) 增加，尤其是由于纤维蛋白原贡献 (FCS) 增加 63.7%。 Quantra 上的凝块溶解稳定性 (CSL) 分析显示值为 100%，表明纤维蛋白溶解不足为 32.4%。年龄 > 65 岁，纤维蛋白原、D-二聚体、LDH 值升高、CS 和 CSL 增加与疾病恶化显着相关。 FCS 和 D-二聚体值升高的组合在区分具有严重症状的患者方面显示出特别高的预后价值。总之，Quantra®系统测量的FCS及其与D-二聚体的结合可以成为识别入院时的COVID-19患者不良预后的有力工具。