Prothrombotic hemostasis disturbances in patients with severe COVID-19: Individual daily data

Hardy, Michaël; Michaux, Isabelle; Lessire, Sarah; Douxfils, Jonathan; Dogné, Jean‐Michel; Bareille, Marion; Horlait, Geoffrey; Bulpa, Pierre; Chapelle, Céline; Laporte, Silvy; Testa, Sophie; Jacqmin, Hugues; Lecompte, T.; Dive, Alain; Mullier, François

doi:10.1016/j.dib.2020.106519

Cited by 21 publications

(16 citation statements)

References 8 publications

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“…The changes in D-dimers levels over time can also help identify patients likely to develop thrombosis, as a D-dimers increment of 1.5-fold was strongly associated with the diagnosis of thrombosis in COVID-19 patients [33] . Progression curves of D-dimers also showed a rapid increase before the diagnosis of thrombotic events [14] , [34] .…”

Section: Methodsmentioning

confidence: 92%

Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021)

Garrigue

Albaladéjo

Blais

et al. 2021

Anaesthesia Critical Care & Pain Medicine

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Section: Methodsmentioning

confidence: 92%

Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021)

Garrigue

Albaladéjo

Blais

et al. 2021

Anaesthesia Critical Care & Pain Medicine

Self Cite

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“…Hardy and colleagues demonstrated enhanced thrombin potential in patients being treated in ICU, using highly sensitive laboratory techniques. 64,65 Increased levels or activities of proteins involved in blood coagulation, such as factor VIII, accompanied by decreased coagulation inhibitors, very strongly suggest a prothrombotic state during COVID-19 disease manifestation. 28,[64][65][66] A feature of this COVID-19-associated prothrombotic state that remains unexplained is the reduction or absence of fibrinolytic variables in both TEG and TEM assays (LY30, LY60, and ML).…”

Section: Discussionmentioning

confidence: 99%

Hemostasis in Coronavirus Disease 2019—Lesson from Viscoelastic Methods: A Systematic Review

2021

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Haemostatic unbalance is often observed in patients with coronavirus disease 2019 (COVID-19), and patients with severe disease are at high risk of developing thromboembolic complications. Viscoelastic methods (VEMs), including thrombelastography (TEG) and thromboelastometry (TEM), provide data on the nature of haemostatic disturbance. In this systematic review, we assessed the performance of TEG and TEM in the assessment of blood coagulation and fibrinolysis in patients with COVID-19. PubMed, Scopus, Web of Science Core Collection, medRxiv and bioRxiv were systematically searched for clinical studies evaluating TEG and/or TEM variables in COVID-19 individuals. Ten studies, with a total of 389 COVID-19 patients, were included, and VEMs were performed in 292 of these patients. Most patients (90%) presented severe COVID-19 and required mechanical ventilation. TEG and TEM variables showed that these patients displayed hypercoagulability and fibrinolysis shutdown, despite the use of appropriate thromboprophylaxis. However, the mechanism underlying these phenomena and their clinical significance in COVID-19 patients who developed thrombosis, is still not clear. Further studies are warranted if VEMs might help to identify those at highest risk of thrombotic events and who therefore may derive the greatest benefit from antithrombotic therapy.

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“…14 Differently, direct mechanisms are linked to the capacity of SARS-CoV-2 to infect endothelial cells through the angiotensin-converting enzyme 2 (ACE2) expressed on their cell membrane, 15,16 to proliferate within the cells and consequently to induce cell damage and apoptosis. 12 Once activated, endothelium reverts its anti-thrombotic phenotype to a prothrombotic one, 17 characterized by increased expression of cell surface adhesion molecules (i.e., ICAM-1, E-selectin, P-selectin, and VCAM-1) 18 ; downregulation of anticoagulant properties (i.e., thrombomodulin [TM], tissue factor pathway inhibitor [TFPI], and heparan sulfate) 19 ; increased expression of procoagulant (Tissue Factor, TF) and antifibrinolytic activities (plasminogen activator inhibitor 1, PAI-1). 20 The upregulation of TF and PAI-1, and downregulation of TM and TFPI, promote hypercoagulation and excessive fibrin formation.…”

Section: Introductionmentioning

confidence: 99%

Endothelium Activation Markers in Severe Hospitalized COVID-19 Patients: Role in Mortality Risk Prediction

Marchetti

Gómez-Rosas

Sanga

et al. 2021

TH Open

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Introduction Endothelial damage and hypercoagulability are major players behind the hemostatic derangement of SARS-CoV-2 infection. Aim In this prospective study we assessed endothelial and inflammatory biomarkers in a cohort of COVID-19 patients, aiming to identify predictive factors of in-hospital mortality. Methods COVID-19 patients hospitalized in intensive care (ICU) and non-ICU units at 2 Bergamo (Italy) hospitals from March 23 to May 30, 2020, were enrolled. Markers of endothelium activation including von-Willebrand factor (vWF), soluble thrombomodulin (sTM), and fibrinolytic proteins (t-PA and PAI-1) were measured. Additionally, D-dimer, Fibrinogen, FVIII, nucleosomes, C reactive protein (CRP) and procalcitonin were assessed. Results Sixty-three (45 ICU, and 18 non-ICU) patients, with a median age of 62 years were analyzed. Increased plasma levels of D-dimer, FVIII, fibrinogen, nucleosomes, CRP, and procalcitonin were observed in the whole cohort. Extremely elevated vWF levels characterized all patients (highest values in ICU-subjects). After a median time of 30 days, death occurred in 13 (21%) patients. By multivariable analysis, vWF-activity, neutrophil-count and PaO2/FiO2 were significantly associated with death. Using these variables, a linear score with 3-risk groups was generated that provided a cumulative incidence of death of 0% in the low-, 32% in the intermediate-, and 78% in the high-risk group. Conclusions COVID-19-induced hemostatic abnormalities are exacerbated by the severity of the disease and strongly correlate with the inflammatory status, underlying the link between coagulation, endothelial activation, and inflammation. Our study provides evidence for a role of vWF, together with neutrophils and PaO2/FiO2, as a significant predictor of in-hospital mortality by SARSCoV-2 infection.

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Prothrombotic hemostasis disturbances in patients with severe COVID-19: Individual daily data

Cited by 21 publications

References 8 publications

Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021)

Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021)

Hemostasis in Coronavirus Disease 2019—Lesson from Viscoelastic Methods: A Systematic Review

Endothelium Activation Markers in Severe Hospitalized COVID-19 Patients: Role in Mortality Risk Prediction

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