J Thromb Haemost
. 2020 Jun 18.
doi: 10.1111/jth.14968. Online ahead of print.
Curative Anticoagulation Prevents Endothelial Lesion in COVID-19 Patients
Lina Khider 1 , Nicolas Gendron 2 3 , Guillaume Goudot 1 , Richard Chocron 4 5 , Caroline Hauw-Berlemont 6 , Charles Cheng 1 , Nadia Rivet 2 , Helene Pere 4 7 , Ariel Roffe 1 , S?bastien Clerc 8 , David Lebeaux 8 , Benjamin Debuc 9 , David Veyer 10 7 , Bastien Rance 11 , Pascale Gaussem 2 3 , S?bastien Bertil 2 3 , C?cile Badoual 12 , Philippe Juvin 13 , Benjamin Planquette 2 14 , Emmanuel Messas 1 , Olivier Sanchez 2 14 , Jean-S?bastien Hulot 4 15 , Jean-Luc Diehl 15 , Tristan Mirault 1 , David M Smadja 2 3
Affiliations
- PMID: 32558198
- DOI: 10.1111/jth.14968
Abstract
Background: Coronavirus disease-2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders.
Objectives: To explore the coagulopathy and endothelial dysfunction in COVID-19 patients.
Methods: Study analyzed clinical and biological profiles of patients with suspected COVID-19 infection at admission, including hemostasis tests and quantification of circulating endothelial cells (CECs).
Results: Among 96 consecutive COVID-19-suspected patients fulfilling criteria for hospitalization, 66 were tested positive for SARS-CoV-2. COVID-19 positive patients were more likely to present with fever (p=0.02), cough (p=0.03) and pneumonia at CT-scan (p=0.002) at admission. Prevalence of D-dimer >500 ng/mL was higher in COVID-19 positive patients (74.2% vs. 43.3%; p=0.007). No sign of disseminated intravascular coagulation were identified. Adding D-dimers >500 ng/mL to gender and pneumonia at CT scan in ROC curve analysis significantly increased AUC for COVID-19 diagnosis. COVID-19 positive patients had significantly more CECs at admission (p=0.008) than COVID-19 negative ones. COVID-19 positive patients treated with curative anticoagulant prior to admission had less CECs (p=0.02) than those without. Interestingly, patients treated with curative anticoagulation and ACEi or ARBs had even lesser CECs (p=0.007).
Conclusion: Curative anticoagulation could prevent COVID-19-associated coagulopathy and endothelial lesion.
Keywords: COVID-19; D-dimers; SARS-CoV-2; circulating endothelial cells; coagulopathy.