TY - JOUR
T1 - Biomarkers of coagulation, endothelial, platelet function, and fibrinolysis in patients with COVID-19
T2 - a prospective study
AU - Manoj, Manoj Job
AU - Chacko, Binila
AU - Selvarajan, Sushil
AU - Peter, John Victor
AU - Geevar, Tulasi
AU - Dave, Rutvi Gautam
AU - Georgy, Josh Thomas
AU - Zachariah, Anand
AU - George, Tina
AU - Sathyendra, Sowmya
AU - Hansdak, Samuel George
AU - Krishnaswami, Rajiv Karthik
AU - Thangakunam, Balamugesh
AU - Gupta, Richa
AU - Karuppusami, Reka
AU - Nair, Sukesh Chandran
AU - Srivastava, Alok
N1 - © 2024. The Author(s).
PY - 2024/12
Y1 - 2024/12
N2 - Prospective and sequential evaluation of homeostatic changes leading to thrombosis across COVID 19 disease severity spectrum are limited. In this prospective observational study, haemostasis was evaluated in patients with mild, moderate-severe, and critical COVID-19 infection. Markers of endothelial activation [Soluble thrombomodulin (sTM), von Willebrand Factor (VWF)], platelet activation [Soluble P-selectin, beta-thromboglobulin (BTG)] and global haemostasis [Rotational thromboelastometry (ROTEM)] were evaluated on days 1 and 5 after admission. The study cohort comprised of 100 adult patients (mild = 20, moderate-severe = 22, critical = 58). Sixty-five patients received anticoagulation for 10 (7–14) days. Thrombotic events were seen in 9 patients. In-hospital mortality was 21%. Endothelial activation markers were elevated at baseline in all subgroups, with levels in moderate-severe (sTM = 4.92 ng/ml, VWF = 295 U/dl) [reference-ranges: sTM = 2.26–4.55 ng/ml; Soluble P-selectin = 13.5–31.5 ng/ml; BTG = 0.034–1.99 ng/ml] and critical patients (sTM = 6.07 ng/ml, VWF = 294 U/dl) being significantly higher than in the mild group (sTM = 4.18 ng/ml, VWF = 206 U/dl). In contrast, platelet activation markers were elevated only in critically ill patients at baseline (Soluble P-selectin = 37.3 ng/ml, BTG = 2.51 ng/ml). The critical group had significantly lower fibrinolysis on days 1 and 5 when compared with the moderate-severe arm. COVID-19 infection was associated with graded endothelial activation and lower fibrinolysis that correlated with illness severity.
AB - Prospective and sequential evaluation of homeostatic changes leading to thrombosis across COVID 19 disease severity spectrum are limited. In this prospective observational study, haemostasis was evaluated in patients with mild, moderate-severe, and critical COVID-19 infection. Markers of endothelial activation [Soluble thrombomodulin (sTM), von Willebrand Factor (VWF)], platelet activation [Soluble P-selectin, beta-thromboglobulin (BTG)] and global haemostasis [Rotational thromboelastometry (ROTEM)] were evaluated on days 1 and 5 after admission. The study cohort comprised of 100 adult patients (mild = 20, moderate-severe = 22, critical = 58). Sixty-five patients received anticoagulation for 10 (7–14) days. Thrombotic events were seen in 9 patients. In-hospital mortality was 21%. Endothelial activation markers were elevated at baseline in all subgroups, with levels in moderate-severe (sTM = 4.92 ng/ml, VWF = 295 U/dl) [reference-ranges: sTM = 2.26–4.55 ng/ml; Soluble P-selectin = 13.5–31.5 ng/ml; BTG = 0.034–1.99 ng/ml] and critical patients (sTM = 6.07 ng/ml, VWF = 294 U/dl) being significantly higher than in the mild group (sTM = 4.18 ng/ml, VWF = 206 U/dl). In contrast, platelet activation markers were elevated only in critically ill patients at baseline (Soluble P-selectin = 37.3 ng/ml, BTG = 2.51 ng/ml). The critical group had significantly lower fibrinolysis on days 1 and 5 when compared with the moderate-severe arm. COVID-19 infection was associated with graded endothelial activation and lower fibrinolysis that correlated with illness severity.
KW - Adult
KW - Humans
KW - Fibrinolysis
KW - Prospective Studies
KW - P-Selectin
KW - von Willebrand Factor
KW - COVID-19
KW - Biomarkers
UR - http://www.scopus.com/inward/record.url?scp=85182857993&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85182857993&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/831c1ba6-f0de-32fb-87fa-fa01926524a7/
U2 - 10.1038/s41598-024-51908-9
DO - 10.1038/s41598-024-51908-9
M3 - Article
C2 - 38263377
AN - SCOPUS:85182857993
SN - 2045-2322
VL - 14
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 2011
ER -