@article{HerrmannNotzSchlesingeretal.2021,
  author    = {Herrmann, Johannes and Notz, Quirin and Schlesinger, Tobias and Stumpner, Jan and Kredel, Markus and Sitter, Magdalena and Schmid, Benedikt and Kranke, Peter and Schulze, Harald and Meybohm, Patrick and Lotz, Christopher},
  title     = {Point of care diagnostic of hypercoagulability and platelet function in COVID-19 induced acute respiratory distress syndrome: a retrospective observational study},
  series = {Thrombosis Journal},
  volume    = {19},
  journal   = {Thrombosis Journal},
  number    = {1},
  doi       = {10.1186/s12959-021-00293-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260739},
  year      = {2021},
  abstract  = {Background Coronavirus disease 2019 (COVID-19) associated coagulopathy (CAC) leads to thromboembolic events in a high number of critically ill COVID-19 patients. However, specific diagnostic or therapeutic algorithms for CAC have not been established. In the current study, we analyzed coagulation abnormalities with point-of-care testing (POCT) and their relation to hemostatic complications in patients suffering from COVID-19 induced Acute Respiratory Distress Syndrome (ARDS). Our hypothesis was that specific diagnostic patterns can be identified in patients with COVID-19 induced ARDS at risk of thromboembolic complications utilizing POCT. Methods This is a single-center, retrospective observational study. Longitudinal data from 247 rotational thromboelastometries (Rotem®) and 165 impedance aggregometries (Multiplate®) were analysed in 18 patients consecutively admitted to the ICU with a COVID-19 induced ARDS between March 12th to June 30th, 2020. Results Median age was 61 years (IQR: 51-69). Median PaO2/FiO2 on admission was 122 mmHg (IQR: 87-189), indicating moderate to severe ARDS. Any form of hemostatic complication occurred in 78 \% of the patients with deep vein/arm thrombosis in 39 \%, pulmonary embolism in 22 \%, and major bleeding in 17 \%. In Rotem® elevated A10 and maximum clot firmness (MCF) indicated higher clot strength. The delta between EXTEM A10 minus FIBTEM A10 (ΔA10) > 30 mm, depicting the sole platelet-part of clot firmness, was associated with a higher risk of thromboembolic events (OD: 3.7; 95 \%CI 1.3-10.3; p = 0.02). Multiplate® aggregometry showed hypoactive platelet function. There was no correlation between single Rotem® and Multiplate® parameters at intensive care unit (ICU) admission and thromboembolic or bleeding complications. Conclusions Rotem® and Multiplate® results indicate hypercoagulability and hypoactive platelet dysfunction in COVID-19 induced ARDS but were all in all poorly related to hemostatic complications..},
  language  = {en}
}
@article{BeckerSperlichZinneretal.2020,
  author    = {Becker, Manuel and Sperlich, Billy and Zinner, Christoph and Achtzehn, Silvia},
  title     = {Intra-Individual and Seasonal Variation of Selected Biomarkers for Internal Load Monitoring in U-19 Soccer Players},
  series = {Frontiers in Physiology},
  volume    = {11},
  journal   = {Frontiers in Physiology},
  number    = {838},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2020.00838},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-209616},
  year      = {2020},
  abstract  = {The aim of this study was to investigate inter-day and -week as well as intra- and inter-individual variation of selected biomarkers in high-performance youth soccer players to assist practitioners interpreting player's internal load to counteract underperformance and unwanted health risks. Eleven male youth soccer players were tested multiple times during two 3-week periods at midpoint (3-wkmid) and at the end (3-wkend) of the first half of a German under-19 1. Bundesliga season. The levels of creatine kinase (CK), urea, and C-reactive protein (CRP) were measured during 3-wkmid and 3-wkend each Monday, Wednesday, and Friday. In 3-wkmid the CK median was 14\% higher (241 vs. 212 U/L) compared to 3-wkend (P = 0.26, ES = 0.16). Overall, the medians of CK, urea (P = 0.59, ES = 0.08), and CRP (P = 0.56, ES = 0.10) during 3-wkmid did not differ to the values of 3-wkend. Daily coefficient of variations (CVs) ranged from 22 to 71\% (CK), 17 to 37\% (urea), and 9 to 164\% (CRP). Individual medians ranged from 101 to 350 U/L (CK), 23 to 50 mg/dL (urea), and 0.6 to 1.1 mg/L (CRP). High intra-individual variability was demonstrated by large intra-individual CVs (medians: CK 50\%, urea 18\%, and CRP 45\%). Our data show (i) large inter-day and inter-week variability of all biomarkers, depending on the external load and (ii) considerable inter- and intra-individual parameter variations. Creatine kinase concentrations could sensitively reflect soccer-specific loads during the season.},
  language  = {en}
}