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COVID-19 Induced Thrombotic Microangiopathy Profile

CPT: 83615; 85240; 85246; 85379; 85397; 86162
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Test Includes

ADAMTS13 Activity; Complement, Total (CH50); D-Dimer; Factor VIII Activity; Lactic Acid Dehydrogenase (LD); von Willebrand Profile


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Specimen Requirements


Specimen

Serum and plasma


Volume

2 mL serum and 4.5 mL plasma (sodium citrate)


Minimum Volume

1 mL serum and 3 mL plasma (sodium citrate) (Note: This volume does not allow for repeat testing.)


Container

Gel-barrier tube and blue-top (sodium citrate) tube


Collection

Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze plasma within four hours of blood collection and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit seperate frozen specimens for each test requested.


Storage Instructions

Frozen: Serum and plasma

Room temperature: Serum


Test Details


Use

Assessment of patients at high risk of COVID-19-associated thrombotic microangiopathy.


Limitations

For von Willebrand Factor (vWF) Antigen [086280]: This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approvedby the Food and Drug Administration.


Methodology

See individual test components.


References

Doevelaar A, Bachmann M, Hölzer B, et al. COVID-19 is associated with relative ADAMTS13 deficiency and VWF multimer formation resembling TTP. medRxiv preprint posted August 25, 2020. doi.org/10.1101/2020.08.23.20177824.
Goshua G, Pine AB, Meizlish ML, et al. Endoteliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. Lancet Haematol. 2020 Aug;7(8):e575-e582.32619411
Jodele S, Fukuda T, Vinks A, et al. Eculizumab Therapy in Children with Severe Hematopoietic Stem Cell Transplantation-Associated Thrombotic Microangiopathy. Biol Blood Marrow Transplant. 2014 Apr;20(4):518-525.24370861
Mancini I, Baronciani L, Artoni A, et al. The ADAMTS13-von Willebrand factor axis in COVID-19 patients. J Thromb Haemost. 2021 Feb;19(2):513-521.33230904

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
164044 COVID-19 Microangiopathy Panel 001941 Complement, Total (CH50) U/mL 4532-8
164044 COVID-19 Microangiopathy Panel 001115 LDH IU/L 2532-0
164044 COVID-19 Microangiopathy Panel 086264 Factor VIII Activity % 3209-4
164044 COVID-19 Microangiopathy Panel 086280 von Willebrand Factor (vWF) Ag % 27816-8
164044 COVID-19 Microangiopathy Panel 115206 D-Dimer mg/L FEU 48065-7
164044 COVID-19 Microangiopathy Panel 117928 ADAMTS13 Activity % 53622-7
164044 COVID-19 Microangiopathy Panel 164045 Induced Thrombotic Panel n/a
Reflex Table for ADAMTS13 Activity
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117917 Comment: 117917 Comment: n/a
Reflex Table for ADAMTS13 Activity
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 117931 Comment 117931 Comment n/a

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