Combined coagulation and inflammation markers as predictors of venous thrombo-embolism and death in COVID-19.

ADAMTS13 C-reactive protein COVID-19 interleukin-6 prognosis thrombosis von Willebrand factor

Journal

Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047

Informations de publication

Date de publication:
2024
Historique:
received: 11 03 2024
accepted: 03 05 2024
medline: 25 6 2024
pubmed: 25 6 2024
entrez: 25 6 2024
Statut: epublish

Résumé

The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively. We investigated the role of prognostic factors from the coagulation or inflammatory pathways to better understand the outcome of the disease. For this, we prospectively studied 167 SARS-CoV-2-positive patients from admission in intensive care units (ICU) or emergency departments from four academic hospitals over a 14-month period. Besides standard biology, we assessed serum concentrations of inflammatory markers, coagulation factors and peripheral blood cells immunophenotyping. Thirty-nine patients (23.3%) developed VT and 30 patients (18%) died. By univariate analysis, C-reactive protein (CRP) level > 150 mg/L, interleukin-6 (IL-6) ≥ 20 pg/mL, D-dimers > 1,500 μg/L, ADAMTS13 activity ≤ 50%, Von. A combination of coagulation and inflammatory markers can refine the prognostication of severe outcome in COVID-19, and could be useful for the initial evaluation of other types of viral infection.

Sections du résumé

Background UNASSIGNED
The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively.
Objectives UNASSIGNED
We investigated the role of prognostic factors from the coagulation or inflammatory pathways to better understand the outcome of the disease.
Methods UNASSIGNED
For this, we prospectively studied 167 SARS-CoV-2-positive patients from admission in intensive care units (ICU) or emergency departments from four academic hospitals over a 14-month period. Besides standard biology, we assessed serum concentrations of inflammatory markers, coagulation factors and peripheral blood cells immunophenotyping.
Results UNASSIGNED
Thirty-nine patients (23.3%) developed VT and 30 patients (18%) died. By univariate analysis, C-reactive protein (CRP) level > 150 mg/L, interleukin-6 (IL-6) ≥ 20 pg/mL, D-dimers > 1,500 μg/L, ADAMTS13 activity ≤ 50%, Von.
Conclusion UNASSIGNED
A combination of coagulation and inflammatory markers can refine the prognostication of severe outcome in COVID-19, and could be useful for the initial evaluation of other types of viral infection.

Identifiants

pubmed: 38915768
doi: 10.3389/fmed.2024.1399335
pmc: PMC11194426
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1399335

Informations de copyright

Copyright © 2024 Zhu, Bouzid, Travert, Géri, Cohen, Picod, Heming, Rottman, Joly-Laffargue, Veyradier, Capron and Coppo.

Déclaration de conflit d'intérêts

PC was member of the Clinical Advisory Board for Alexion, Sanofi, Takeda, and Janssen. AV had participated to Advisory boards for Sanofi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Jaja Zhu (J)

Service d'Hématologie-Immunologie-Transfusion, AP-HP Paris Saclay, CHU Ambroise Paré, Université de Versailles Saint Quentin-Université Paris Saclay, Montigny-le-Bretonneux, France.
Laboratoire Cellules Souches et Applications Thérapeutiques, UMR INSERM 1184, Commissariat à l'Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, France.

Raïda Bouzid (R)

Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT), AP-HP, Paris, France.

Benoît Travert (B)

Service de Médecine Interne, Hôpital Ambroise-Paré, AP-HP, Boulogne-Billancourt, France.

Guillaume Géri (G)

Service de Médecine Intensive et Réanimation, Hôpital Ambroise-Paré, AP-HP, Boulogne-Billancourt, France.

Yves Cohen (Y)

Service de Médecine Intensive et Réanimation, Hôpital Avicenne, AP-HP, Paris, France.

Adrien Picod (A)

Service de Médecine Intensive et Réanimation, Hôpital Avicenne, AP-HP, Paris, France.

Nicholas Heming (N)

Department of Intensive Care, Raymond Poincaré Hospital, APHP University Versailles Saint Quentin-University Paris Saclay, Garches, France.
Institut Hospitalo Universitaire PROMETHEUS, Garches, France.
Innovative Biomarkers Plateform, Laboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France.
FHU SEPSIS, Garches, France.

Martin Rottman (M)

Innovative Biomarkers Plateform, Laboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France; FHU SEPSIS, Garches, France.
General Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), FHU SEPSIS, Laboratory of Infection and Inflammation-U1173, School of Medicine Simone Veil, Université Versailles Saint Quentin, University Paris Saclay, INSERM, Garches, France.

Bérangère Joly-Laffargue (B)

Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT), AP-HP, Paris, France.
EA3518, Institut de Recherche Saint Louis, Université de Paris, Paris, France.
Service D'hématologie Biologique, Laboratoire ADAMTS13, Hôpital Lariboisière, AP-HP Nord, Université de Paris, Paris, France.

Agnès Veyradier (A)

Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT), AP-HP, Paris, France.
EA3518, Institut de Recherche Saint Louis, Université de Paris, Paris, France.
Service D'hématologie Biologique, Laboratoire ADAMTS13, Hôpital Lariboisière, AP-HP Nord, Université de Paris, Paris, France.

Claude Capron (C)

Service d'Hématologie-Immunologie-Transfusion, AP-HP Paris Saclay, CHU Ambroise Paré, Université de Versailles Saint Quentin-Université Paris Saclay, Montigny-le-Bretonneux, France.
Université Paris-Saclay, Université de Versailles Saint Quentin en Yvelines (UVSQ), Biomarqueurs en cancérologie et onco-hématologie (BECCOH), Boulogne-Billancourt, France.

Paul Coppo (P)

Centre de Référence des Microangiopathies Thrombotiques (CNR-MAT), AP-HP, Paris, France.
Service d'Hématologie, Hôpital Saint-Antoine, AP-HP-Sorbonne Université, Paris, France.
NSERM UMRS 1138, Centre de Recherche des Cordeliers, Paris, France.

Classifications MeSH