Monitoring Deep Vein Thrombosis in COVID-19 Patients

Quan Le, Jeremiah Carpenter, Rachel Anderson, Melissa McCullough, Angela Alexander-Bryant
Department of Bioengineering, Clemson University, Clemson, SC 29632, USA

Introduction

  • A common symptom of COVID-19 is deep vein thrombosis (DVT) due to the effect of increasing the liver’s production of clotting factors
    Figure 1: DVT effect on leg of patient

    Figure 1: DVT effect on leg of patient [2]

  • 70.7% of patients in one study had blood stasis which is known to lead to high incidents of thrombosis [3]
  • High D-dimer levels are associated with blood clotting
  • 97% of COVID-19 patients have been associated with elevated D-dimer levels
  • D-dimers are important to monitor because they are a direct result of dissolved blood clots
  • Specifically, D-dimers are a degradation product of fibrin, a protein in blood that is involved in producing blood clots
  • For most adults, the reference for normal D-dimers levels is approximately 500 ng/mL of fibrinogen equivalent units

Materials

  • Connector point
  • Heparin reservoir
  • Peristaltic pump
  • Flowmeter
  • D-dimer sensor
  • Catheter
Figure 2: Block diagram of internal device function

Figure 2: Block diagram of internal device function

Potential Impacts

  • Target population:
    • COVID-19 patients admitted in hospital
  • Continuous monitoring system
    • 15 mL sample every hour
  • Electrochemical impedance spectroscopy (EIS) as method of detecting d-dimers [1]
  • Can be implemented for other diseases/conditions:
    • postpartum/pregnancy care
    • sickle cell disease
    • inflammatory bowel disease
    • heart disease
    • lung disease
Capture

Figure 3: Catheter attached to patient for blood drawings [4]

Future Work

  • Development phase
  • Testing phase
  • NIH grant
    • “Emergency Awards: Rapid Investigation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease 2019 (COVID-19) (R21 Clinical Trial Not Allowed)”
  • Partnership with PRISMA Health or a research institution such as MUSC 

References

  1. Chebil, S., et al. “Electrochemical Detection of d-Dimer as Deep Vein Thrombosis Marker Using Single-Chain d-Dimer Antibody Immobilized on Functionalized Polypyrrole.” Biosensors and Bioelectronics, Elsevier, 3 July 2010, www.sciencedirect.com/science/article/pii/S0956566310003490.
  2. Home Health Care. “What Is DVT? Deep Vein Thrombosis Symptoms, Treatment & More.” Sonas Home Health Care, Sonas Home Health Care, 17 Oct. 2019, www.sonashomehealth.com/what-is-deep-vein-thrombosis/.
  3. Kerbikov, Oleg B, et al. “High Incidence of Venous Thrombosis in Patients with Moderate to Severe COVID-19.” MedRxiv, Cold Spring Harbor Laboratory Press, 1 Jan. 2020, www.medrxiv.org/content/10.1101/2020.06.12.20129536v1.
  4. McAlpine, Kate. “Biopsy Alternative: ‘Wearable’ Device Captures Cancer Cells from Blood.” Michigan Engineering, The Regents of the University of Michigan Ann Arbor, 1 Apr. 2019, news.engin.umich.edu/2019/04/biopsy-alternative-wearable-device-captures-cancer-cells-from-blood/.
  5. Mycroft-West, Courtney, et al. “The 2019 Coronavirus (SARS-CoV-2) Surface Protein (Spike) S1 Receptor Binding Domain Undergoes Conformational Change upon Heparin Binding.” BioRxiv, Cold Spring Harbor Laboratory, 1 Jan. 2020, www.biorxiv.org/content/10.1101/2020.02.29.971093v2.full.
  6. Yao, Chunyan, et al. “Detection of Fibrinogen and Coagulation Factor VIII in Plasma by a Quartz Crystal Microbalance Biosensor.” MDPI, Multidisciplinary Digital Publishing Institute, 24 May 2013, www.mdpi.com/1424-8220/13/6/6946/htm.

Acknowledgements

We would like to thank Miss Melissa McCullough and Dr. Angela Alexander-Bryant for their mentorships, and the Clemson Creative Inquiry Program for their role in this project.