tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Nicolas Gendron[SUP] 2 3 [/SUP], Guillaume Goudot[SUP] 1 [/SUP], Richard Chocron[SUP] 4 5 [/SUP], Caroline Hauw-Berlemont[SUP] 6 [/SUP], Charles Cheng[SUP] 1 [/SUP], Nadia Rivet[SUP] 2 [/SUP], Helene Pere[SUP] 4 7 [/SUP], Ariel Roffe[SUP] 1 [/SUP], S?bastien Clerc[SUP] 8 [/SUP], David Lebeaux[SUP] 8 [/SUP], Benjamin Debuc[SUP] 9 [/SUP], David Veyer[SUP] 10 7 [/SUP], Bastien Rance[SUP] 11 [/SUP], Pascale Gaussem[SUP] 2 3 [/SUP], S?bastien Bertil[SUP] 2 3 [/SUP], C?cile Badoual[SUP] 12 [/SUP], Philippe Juvin[SUP] 13 [/SUP], Benjamin Planquette[SUP] 2 14 [/SUP], Emmanuel Messas[SUP] 1 [/SUP], Olivier Sanchez[SUP] 2 14 [/SUP], Jean-S?bastien Hulot[SUP] 4 15 [/SUP], Jean-Luc Diehl[SUP] 15 [/SUP], Tristan Mirault[SUP] 1 [/SUP], David M Smadja[SUP] 2 3 [/SUP]
Affiliations
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.
. 2020 Jun 18.
doi: 10.1111/jth.14968. Online ahead of print.
Curative Anticoagulation Prevents Endothelial Lesion in COVID-19 Patients
Lina Khider[SUP] 1 [/SUP], Nicolas Gendron[SUP] 2 3 [/SUP], Guillaume Goudot[SUP] 1 [/SUP], Richard Chocron[SUP] 4 5 [/SUP], Caroline Hauw-Berlemont[SUP] 6 [/SUP], Charles Cheng[SUP] 1 [/SUP], Nadia Rivet[SUP] 2 [/SUP], Helene Pere[SUP] 4 7 [/SUP], Ariel Roffe[SUP] 1 [/SUP], S?bastien Clerc[SUP] 8 [/SUP], David Lebeaux[SUP] 8 [/SUP], Benjamin Debuc[SUP] 9 [/SUP], David Veyer[SUP] 10 7 [/SUP], Bastien Rance[SUP] 11 [/SUP], Pascale Gaussem[SUP] 2 3 [/SUP], S?bastien Bertil[SUP] 2 3 [/SUP], C?cile Badoual[SUP] 12 [/SUP], Philippe Juvin[SUP] 13 [/SUP], Benjamin Planquette[SUP] 2 14 [/SUP], Emmanuel Messas[SUP] 1 [/SUP], Olivier Sanchez[SUP] 2 14 [/SUP], Jean-S?bastien Hulot[SUP] 4 15 [/SUP], Jean-Luc Diehl[SUP] 15 [/SUP], Tristan Mirault[SUP] 1 [/SUP], David M Smadja[SUP] 2 3 [/SUP]
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.