Multiplexed device for rapid coagulopathy testing

摘要 新冠肺炎已经成为一个全球健康挑战，报告的病例超过3700万例，其中1079,029例 死亡人数(根据世卫组织网站，截至2020年10月13日)。尽管凝血疾病的确切病因学 在新冠肺炎中尚不清楚，肺组织受损，细胞因子水平升高和血液化学改变所致 对炎症和败血症都有可能起到作用。由此产生的不适当止血(制作过程 血栓止血)是这些患者护理中的一大挑战。重要的是，凝结作用 新冠肺炎患者的特征--以及相应的医疗治疗--可能会因时间而异 到一小时了。因为无症状的患者可能会发生危及生命的凝血障碍相关血栓事件， 对凝血功能异常进行可靠、频繁和廉价的检测将有助于识别高危患者。 目前用于临床评估凝血状态的方法繁琐、昂贵且范围有限， 临床医生对新冠肺炎缺乏强大的工具来解决凝血障碍感到沮丧。利用我们的 在血液凝固病、新冠肺炎管理和微流体技术方面的专业知识，我们建议发展 以及提高对新冠肺炎阳性患者凝血状态诊断的检测技术。这个 技术很简单，但却是多元的，取代了目前临床上使用的多重血液测试。因为 血液样本始终包含在设备中，接触受感染血液的风险降至最低。它使用 挑战血液通过血管样通道的仿生原理，这些通道经过特定的 凝血因子。我们将优化设备的设计，并根据现有的测试来验证其性能 方法：研究方法。该项目完成后，将为快速、重复的关注点测试提供新技术 凝血障碍在新冠肺炎等多种临床应用。

Abstract COVID-19 has emerged as a global health challenge, with more than 37 million cases reported and 1,079,029 deaths (as of October 13, 2020 according to the WHO website). Although the precise etiology of coagulopathies in COVID-19 is not clear, damage to lung tissue, increased cytokine levels and alteration of blood chemistry due to inflammation and sepsis all likely contribute. The resulting inappropriate hemostasis (the process of making blood clots to stop bleeding) is a major challenge in the care of these patients. Importantly, the coagulation profile of a COVID-19 patient – and consequently the appropriate medical treatment – might change from hour to hour. Because asymptomatic patients can develop life-threatening coagulopathy-related thrombotic events, robust, frequent and inexpensive tests for blood coagulation aberrations would help identify at-risk patients. Current methods for clinical assessment of coagulation status are cumbersome, expensive and limited in scope, and clinicians are frustrated by the lack of robust tools to address coagulopathy in COVID-19. Leveraging our expertise in blood coagulopathy, COVID-19 management and microfluidics technology, we propose to develop and test technology for improving diagnosis of blood coagulation status in COVID-19-positive patients. The technology is simple, but multiplexed, replacing multiple blood tests currently used in the clinic. Because the blood sample is always contained within the device, risk of exposure to infected blood is minimized. It uses biomimetic principles to challenge blood to flow through vascular-like channels that are pre-treated with specific coagulation factors. We will optimize the design of the device and validate its performance against existing assay methods. When complete, this project will provide new technology for rapid, repeated point of care testing of blood coagulopathy in COVID-19 and other diverse clinical applications.