Cryofibrinogenemia in PRECOVID-19 and COVID-19 Periods: Single University Study in Northern Spain

Cryofibrinogenemia (CF) may be secondary to COVID-19. To establish this relationship, in PRECOVID-19 and COVID-19 periods we assess: (a) frequency and clinical features in patients with CF; (b) study of CF syndrome. We study all cryofibrinogen tests performed in a single university hospital in Northern Spain, comparing two periods: PRECOVID-19 (July 2017–February 2020) and COVID-19 (March 2020–October 2022). CF syndrome was established with two positive cryofibrinogen tests plus compatible cutaneous manifestations and/or thrombotic events (TE). CF was found in 129/279 patients. In the COVID-19 period, they had more positive tests (50.2% vs. 28%; p = 0.0047), younger age (33 vs. 55 years, p = 0.054) and fewer cardiovascular (CV) risk factors (39.1% vs. 78.6%, p = 0.005). Cutaneous manifestations were the most frequent in both periods (81.4%), particularly purpuric macules (29.5%). Skin ulcers showed statistically significant differences, being more frequent in the PRECOVID-19 era (35.7% vs. 7.8%, p = 0.008). Thrombotic CV events were also observed (13.2%), particularly venous thromboembolisms (12.2%). Severe complications were more frequent in the PRECOVID-19 era, although this difference did not reach statistical significance (35.7% vs. 19.1%; p = 0.169). CF was secondary in 68/129 cases, mainly to SARS-CoV-2 (n = 45). CF syndrome was found in 27.9% of patients. After one year, most patients were clinically stable or in remission. Mild dermatological lesions were the most frequent manifestations, and most patients recovered.