White blood count, D‐dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID‐19 patients: The French multicenter CLOTVID retrospective study

Galland, J.; Thoreau, Benjamin; Neuwirth, Marie; Chauvin, Anthony; Dellal, Azeddine; Nallet, O.; Roriz, Mélanie; Devaux, Mathilde; London, Jonathan; Martin‐Lecamp, Gonzague; Froissart, Antoine; Arab, N; Ferron, B; Groff, Marie‐Helene; Queyrel, V.; Lorut, Christine; Regard, Lucile; Berthoux, E.; Bayer, Guillaume; Comarmond, C.; Lioger, Bertrand; Mékinian, A.; Szwebel, Tali‐Anne; Sené, Thomas; Amador‐Boreiro, Blanca; Mangin, O.; Sellier, Pierre‐Olivier; Mouly, Stéphane; Kévorkian, Jean-Philippe; Vodovar, Dominique; Sène, Damien; Mathieu, Albertini; Bouajila, Sara; Kimbimbi, Britany; Burlacu, Ruxandra; Cacoub, Lea; Champion, Karine; Delcey, Véronique; Jean‐Guillaume, Dillinger; Féron, Florine; Frazier, Aline; Funck‐Bretano, Thomas; Diane‐Cecile, Gauthier; Jean‐François, Gautier; Henry, Patrick; Huscenot, Tessa; Izabel, Sarah; Jaulerry, Mathilde; Moenes, Jouabli; Jean‐Baptiste, Julla; Marie, Laloi Michelin; Leblond, Pierre; Lopes, Amanda; Mégarbane, Bruno; Maxime, Michon; Anne‐Lise, Munier; Nahmani, Yoram; Nicol, Martin; Eroan, Nicolas; Audrey, P.; Revue, Eric; Richette, Pascal; Jean‐Pierre, Riveline; Rubenstein, Emma; Adrien, Zanin; Aveneau, Clément; Bastard, Paul; Diane, Beauvais; Loredana, Boghez; Alix, Borderiou; Conway, Paul; Lavignia, Cosma; Davy, Vincent; Clément, Desjardin; Sandra, Devatine; Christel, Ducroz Gerardin; Charlotte, Dupe; Chloé, Gobert; Clotilde, Gros; Soumaya, Kadiri; Enmat, Khan; Sandrine, Ongnessek; Fatima, Rhmari; Sacco, Isabelle; Natalia, Saptefrat; Pauline, Schaupp; Justine, Serre; Sidéris, Georgios; Sonia, Smati; Marine, Tournier; Pauline, T; Tony, Truong; Mathilde, Tuffier; Arcelli, Mattéo; Boué, Yvonnick; Alban, Copie; Deye, Nicolas; Ekhérian, Jean-Michel; Errabih, Zaccaria; Gonde, Antoine; Grant, Caroline A.; Guerin, Emmanuelle; Magalhães, A. E. B. M. De; Malissin, Isabelle; Edouard, Meurisse; Mrad, Aymen; Naim, Giulia; Nguyên, Philippe; Nitenberg, Kiyoko; Adrien, Pepin‐Lehalleur; Arthur, Perault; Perrin, Lucile; Maxime, Renaud; Sütterlin, Laetitia; Delrue, Maxime; Siguret, V.; Stepanian, Alain

doi:10.1111/ejh.13638

Cited by 17 publications

(13 citation statements)

References 45 publications

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“…In particular, the D-dimer was found positively associated with CRP, serum ferritin, PCT, and IL-2R. However, the elevated ferritin level was reported to promote a hypercoagulable state in COVID-19 [93] . In the context of coagulopathy, IL-6 potentially induces megakaryopoiesis and coagulation factors including TF, fibrinogen and factor VIII.…”

Section: Sars-cov-2 Induced Inflammation and Coagulopathymentioning

confidence: 90%

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Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

Ahmad

Kannan

Ansari

2022

Cytokine & Growth Factor Reviews

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Severe COVID-19 patients frequently present thrombotic complications which commonly lead to multiorgan failure and increase the risk of death. Severe SARS-CoV-2 infection induces the cytokine storm and is often associated with coagulation dysfunction. D-dimer, a hallmark of venous thromboembolism (VTE), is observed at a higher level in the majority of hospitalized COVID-19 patients. The precise molecular mechanism of the disproportionate effect of SARS-CoV-2 infection on the coagulation system is largely undefined. SARS-CoV-2 –induced endotheliopathy and, induction of cytokines and growth factors (GFs) most likely play important roles in platelet activation, coagulopathy, and VTE. Generally, viral infections lead to systemic inflammation and induction of numerous cytokines and GFs and many of them are reported to be associated with increased VTE. Most importantly, platelets play key thromboinflammatory roles linking coagulation to immune mediators in a variety of infections including response to viral infection. Since the pathomechanism of coagulopathy and VTE in COVID-19 is largely undefined, herein we highlight the association of dysregulated inflammatory cytokines and GFs with thrombotic complications and coagulopathy in COVID-19.

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Section: Sars-cov-2 Induced Inflammation and Coagulopathymentioning

confidence: 90%

Section: Sars-cov-2 Induced Inflammation and Coagulopathymentioning

confidence: 90%

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

Ahmad

Kannan

Ansari

2022

Cytokine & Growth Factor Reviews

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“…Several authors have suggested tailoring the D-dimer level threshold to the specific context of COVID-19. Levels of 1000, 2000, 3000, or even higher than 6000 µg/L have been suggested to better identify patients with PE [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Strategies to safely rule out pulmonary embolism in COVID-19 outpatients: a multicenter retrospective study

et al. 2023

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ObjectivesThe objective was to define a safe strategy to exclude pulmonary embolism (PE) in COVID-19 outpatients, without performing CT pulmonary angiogram (CTPA). Methods COVID-19 outpatients from 15 university hospitals who underwent a CTPA were retrospectively evaluated. D-Dimers, variables of the revised Geneva and Wells scores, as well as laboratory findings and clinical characteristics related to COVID-19 pneumonia, were collected. CTPA reports were reviewed for the presence of PE and the extent of COVID-19 disease. PE rule-out strategies were based solely on D-Dimer tests using different thresholds, the revised Geneva and Wells scores, and a COVID-19 PE prediction model built on our dataset were compared. The area under the receiver operating characteristics curve (AUC), failure rate, and efficiency were calculated. Results In total, 1369 patients were included of whom 124 were PE positive (9.1%). Failure rate and efficiency of D-Dimer > 500 µg/l were 0.9% (95%CI, 0.2-4.8%) and 10.1% (8.5-11.9%), respectively, increasing to 1.0% (0.2-5.3%) and 16.4% (14.4-18.7%), respectively, for an age-adjusted D-Dimer level. D-dimer > 1000 µg/l led to an unacceptable failure rate to 8.1% (4.4-14.5%). The best performances of the revised Geneva and Wells scores were obtained using the age-adjusted D-Dimer level. They had the same failure rate of 1.0% (0.2-5.3%) for efficiency of 16.8% (14.7-19.1%), and 16.9% (14.8-19.2%) respectively. The developed COVID-19 PE prediction model had an AUC of 0.609 (0.594-0.623) with an efficiency of 20.5% (18.4-22.8%) when its failure was set to 0.8%. Conclusions The strategy to safely exclude PE in COVID-19 outpatients should not differ from that used in non-COVID-19 patients. The added value of the COVID-19 PE prediction model is minor. Key Points• D-dimer level remains the most important predictor of pulmonary embolism in COVID-19 patients.• The AUCs of the revised Geneva and Wells scores using an age-adjusted D-dimer threshold were 0.587 (95%CI, 0.572 to 0.603) and 0.588 (95%CI, 0.572 to 0.603). • The AUC of COVID-19-specific strategy to rule out pulmonary embolism ranged from 0.513 (95%CI: 0.503 to 0.522) to 0.609 (95%CI: 0.594 to 0.623).

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“…They speculated on the role of ferritin in pathogenesis of lung damage but underlined the need for further research supplemented with radiological analysis. Moreover, different studies reported higher ferritin levels in patients with pulmonary embolism caused by COVID-19 compared to non-pulmonary embolism patients [ 57 , 58 ]. In this study patients with severe COVID-19 complicated with pulmonary embolism were analyzed.…”

Section: Discussionmentioning

confidence: 99%

The analysis of Fe-dependent serum enzymes in severe COVID-19 with a pulmonary thrombotic event

Bakiera¹,

Grochowski²,

Strzelec-Pawełczak³

et al. 2022

cejoi

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Introduction COVID-19 patients in critical condition requiring ICU admission are more likely to experience thromboembolic complications, especially pulmonary embolism. Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have struggled with the attempt to diagnose and manage the severe and fatal complications of COVID-19 appropriately. Several reports have described significant procoagulatory events, including life-threatening pulmonary embolism, in these patients. The aim of the study was to analyze the results of selected serum enzymes in patients with a radiologically confirmed pulmonary thrombotic event based on the pulmonary tissue involvement assessed in a computed tomography (CT) scan. Material and methods The retrospective study covered a group of 226 COVID-19 patients. Groups were divided based on the degree of lung tissue involvement in CT examinations, including patients with confirmed pulmonary embolism. The analyzed group consisted of 136 men and 90 women with mean age of 70 years. Results The group consisted of patients with < 50% of lung volume changes who had higher parameter values in each analyzed parameter, except red blood cells (RBC) (p < 0.05). Especially, the level of ferritin was much higher in the first group (p = 0.000008). Elevated ferritin levels were observed in all patients with lung tissue involvement. Discussion This line of research is critical in order to assess the predisposing conditions for pulmonary embolism occurrence in COVID-19, which can be used as a predictive factor for course of the disease. The conducted research will resolve whether there is a relationship between the selected laboratory parameters and the occurrence of pulmonary embolism in patients with COVID-19. Conclusions The study demonstrated that elevated levels of several inflammatory and thrombotic parameters such as ferritin, D-dimer, C-reactive protein (CRP) as well as hemoglobin do not correlate with the degree of lung tissue involvement in the computed tomography image.

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White blood count, D‐dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID‐19 patients: The French multicenter CLOTVID retrospective study

Cited by 17 publications

References 45 publications

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

Role of SARS-CoV-2 -induced cytokines and growth factors in coagulopathy and thromboembolism

Strategies to safely rule out pulmonary embolism in COVID-19 outpatients: a multicenter retrospective study

The analysis of Fe-dependent serum enzymes in severe COVID-19 with a pulmonary thrombotic event

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