Automated measurement of coagulation and fibrinolytic activation markers: Outcomes in coronavirus disease 2019 (COVID-19) patients

被引:4
作者
Gardiner, Chris [1 ]
Mackie, Ian J. [2 ]
MacCallum, Peter [3 ,4 ]
Platton, Sean [5 ,6 ]
机构
[1] Leeds Teaching Hosp NHS Trust, St James Univ Hosp, Specialist Lab Med, Leeds LS9 7TF, W Yorkshire, England
[2] UCL, Haemostasis Res Unit, London, England
[3] Queen Mary Univ London, Wolfson Inst Populat Hlth, London, England
[4] Barts Hlth NHS Trust, Dept Haematol, London, England
[5] Barts Hlth NHS Trust, Royal London Haemophilia Ctr, London, England
[6] Barts Hlth NHS Trust, NHS East & South East London Pathol Partnership, London, England
关键词
chemiluminescent assays; COVID-19; fibrinolysis; thrombomodulin; vascular endothelium;
D O I
10.1111/ijlh.13855
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Severe coronavirus disease 2019 (COVID-19) is characterized by marked hypoxaemia and lung oedema, often accompanied by disordered blood coagulation and fibrinolytic systems, endothelial damage and intravascular fibrin deposition. Patients/Methods We present a retrospective observational study of 104 patients admitted to hospital with COVID-19. Plasma samples were collected within 72 h of admission. In addition to routine coagulation and haematology testing, soluble thrombomodulin (sTM), thrombin-antithrombin (TAT), tissue plasminogen activator-plasminogen activator inhibitor 1 complex (tPAI-C) and plasmin-alpha 2 antiplasmin complex (PIC) were performed by automated chemiluminescent enzyme immunoassays. Results Significantly higher levels of D-dimer, TAT, sTM and tPAI-C were observed in non-survivors compared to survivors. To confirm which parameters were independent risk factors for mortality, multiple logistic regression was performed on D-dimer, TAT. sTM, tPAI-C and PIC data. Only increasing sTM was significantly associated with mortality, with an odds ratio of 1.065 for each 1.0 TU/mL increment (95% CI 1.025-1.115). Conclusions Of the haemostatic variables measured, sTM, which can be rapidly assayed, is the best independent predictor of mortality in patients hospitalized with COVID-19, and this suggests that endothelial dysfunction plays an important role in disease progression.
引用
收藏
页码:817 / 822
页数:6
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