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Background: Cryofibrinogenemia (CF) is the presence of cryofibrinogen in plasma. The presence of CF can be asymptomatic or to develop a CF syndrome. The first clinical manifestation are mainly cutaneous and thrombotic events. Two subtypes of CF syndrome are described: primary (essential) or secondary to other disorders, such as connectivopathies, vasculitis, infections, or tumors [1,2]. Objectives: To compare in the COVID-19 vs the preCOVID-19 era the a) prevalence of CF and b) severity of clinical manifestations of CF syndrome. Methods: Single center, observational, retrospective study of 129 patients with at least one positive cryofibrinogen determination for 31 months from July 2017 to March 2020 (preCOVID-19 era) and from March 2020 to October 2022 (COVID-19 era) at the leading hospital in Cryofibrinogenemia research group in Northern Spain. CF syndrome was diagnosed accordingly to reported criteria (two positive test plus cutaneous manifestations or thrombotic events). We collected clinical, and laboratory parameters, including immunological test. Blood samples were collected in citrated tubes for CF detection and must be kept at 37-C to prevent autoabsorption of cryofibrinogen by red blood cells. Statistical analysis was performed using SPSS software. Qualitative variables were compared using the chi-squared test. Quantitative variables were compared using the student`s t. Results: Positive CF test were found in 129 patients of a total of 266 performed (13/49 (36.1%) in preCOVID-19 era vs 116/230 (50.4%) in COVID-19 era) (Figure 1). Patients from COVID era compared with preCOVID were more frequently men (53.4 vs 46.2%), younger (median age; 39.7 vs 54.2 years and, with lower Cardiovascular Risk Factors (CVRF) (40.5 vs 69.2%). Although they developed a higher CF syndrome (29.3 vs 15.4%), especially secondary, the severity was lower (16.4 vs 30.8%) (Table 1). Most of these severe complications were related to Venous Thromboembolism (VTE) and other types of thrombosis manifestations such as: Acute myocardial infarction (AMI), stroke, Central Retinal Vein thrombosis (CRVT) and Leriche syndrome (Table 1 and Figure 1). Conclusion: Positive CF test and CF syndrome (mainly secondary) were increased in COVID-19 era. However, this CF syndrome was less severe. REFERENCES: [1] Grada A, Falanga V. Cryofibrinogenemia-Induced Cutaneous Ulcers: A Review and Diagnostic Criteria. Am J Clin Dermatol. 2017 Feb;18(1):97-104. doi: 10.1007/s40257-016-0228-y. PMID: 27734332. [2] Santiago MB, Melo BS. Cryofibrinogenemia: What Rheumatologists Should Know. Curr Rheumatol Rev. 2022;18(3):186-194. doi: 10.2174/1573397118666220325110737. PMID: 35339184. Acknowledgements: NIL. Disclosure of Interests: Carmen Lasa-Teja: None declared, Amparo Sánchez López: None declared, Maria Enriqueta Peiró Callizo: None declared, Mónica Renuncio García: None declared, Adrián Martín-Gutiérrez: None declared, Carmen Secada-Gómez: None declared, Juan Irure-Ventura: None declared, Marcos López Hoyos: None declared, Ricardo Blanco AbbVie, MSD, and Roche., AbbVie, Pfizer, Roche, Bristol-Myers, Lilly, Galapagos, Novartis, Janssen, GSK, and MSD.
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Lasa-Teja et al. (2024) studied this question.
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