Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

Berger, Amy; Simchoni, Noa; Auerbach, Andrew D.; Brode, W Michael; Kuperman, Ethan; Raffel, Katie E; Kubey, Alan

doi:10.1001/jamanetworkopen.2022.5657

Cited by 2 publications

(3 citation statements)

References 4 publications

(8 reference statements)

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“…43 This observation was later supported by high quality randomized controlled trials that revealed aspirin or clopidogrel minimally impact patient outcomes following SARS-CoV-2 infection. 44 , 45 Unlike COVID-19, the current study suggests differences in platelet activation through the thromboxane receptor and the glycoprotein VI receptor. Whether those differences translate to changes in patient outcomes in patients with PASC would be speculative and would require the rigor of a prospective, double-blinded, randomized controlled study.…”

Section: Discussionmentioning

confidence: 60%

Dysregulated platelet function in patients with postacute sequelae of COVID-19

Aggarwal,

Singh,

Pham

et al. 2024

Vasc Med

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Background: Postacute sequelae of COVID-19 (PASC), also referred to as “Long COVID”, sometimes follows COVID-19, a disease caused by SARS-CoV-2. Although SARS-CoV-2 is well known to promote a prothrombotic state, less is known about the thrombosis risk in PASC. Our objective was to evaluate platelet function and thrombotic potential in patients following recovery from SARS-CoV-2, but with clear symptoms of patients with PASC. Methods: patients with PASC and matched healthy controls were enrolled in the study on average 15 months after documented SARS-CoV-2 infection. Platelet activation was evaluated by light transmission aggregometry (LTA) and flow cytometry in response to platelet surface receptor agonists. Thrombosis in platelet-deplete plasma was evaluated by Factor Xa activity. A microfluidics system assessed thrombosis in whole blood under shear stress conditions. Results: A mild increase in platelet aggregation in patients with PASC through the thromboxane receptor was observed, and platelet activation through the glycoprotein VI (GPVI) receptor was decreased in patients with PASC compared to age- and sex-matched healthy controls. Thrombosis under shear conditions as well as Factor Xa activity were reduced in patients with PASC. Plasma from patients with PASC was an extremely potent activator of washed, healthy platelets – a phenomenon not observed when stimulating healthy platelets after incubation with plasma from healthy individuals. Conclusions: patients with PASC show dysregulated responses in platelets and coagulation in plasma, likely caused by a circulating molecule that promotes thrombosis. A hitherto undescribed protective response appears to exist in patients with PASC to counterbalance ongoing thrombosis that is common to SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 60%

Dysregulated platelet function in patients with postacute sequelae of COVID-19

Aggarwal,

Singh,

Pham

et al. 2024

Vasc Med

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“…109 Antiplatelet agents, such as P2Y12 inhibitors, are commonly used to prevent thrombotic events but may also impact inflammation through effects on cytokine release, platelet-leukocyte interactions, and NET formation, suggesting potential utility in modulating thromboinflammatory responses. 110 Targeting platelet roles in immunity and inflammation through selectin ligand biologic antagonisms and beyond has been explored in thrombosis and inflammatory disease. 111,112 Overall, targeting platelet-leukocyte interactions and platelet-derived inflammatory mediators could provide novel strategies for managing SIRS and trauma-related complications.…”

Section: Therapeutics Targeting Thromboinflammationmentioning

confidence: 99%

“…Anticoagulant therapies, such as heparins, have been considered for targeting hypercoagulability and modulating inflammation in thromboinflammatory diseases 109 . Antiplatelet agents, such as P2Y12 inhibitors, are commonly used to prevent thrombotic events but may also impact inflammation through effects on cytokine release, platelet-leukocyte interactions, and NET formation, suggesting potential utility in modulating thromboinflammatory responses 110 . Targeting platelet roles in immunity and inflammation through selectin ligand biologic antagonisms and beyond has been explored in thrombosis and inflammatory disease 111,112 .…”

Section: Clinical and Therapeutic Implicationsmentioning

confidence: 99%

The intersection of coagulation activation and inflammation after injury: What you need to know

Costantini,

Kornblith,

Pritts

et al. 2023

J Trauma Acute Care Surg

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The systemic inflammatory response syndrome (SIRS) after severe injury can lead to distant organ injury, multi-organ failure, and complications during recovery. Post-injury SIRS is driven by the activation of innate immune cells and release of pro-inflammatory cytokines that drives this inflammation response. In addition, the coagulation cascade and complement system is altered, resulting in a widespread inflammatory response. Importantly, these different components of SIRS are interrelated and propagate further alterations in thrombosis and inflammation. Efforts to mitigate the acute changes in coagulation and inflammation and its complex interactions following injury could provide novel strategies for resuscitation and management of complications of trauma-induced coagulopathy, SIRS, and multiple organ failure. In this review, we review the pathophysiology of post-traumatic SIRS and highlight current approaches to mitigate innate immune cell activation, thromboinflammation, and associated clinical complications. Level of Evidence IV, Review article

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Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers

Abstract: This survey study assesses the rate at which US academic medical centers have adopted evidenced-based guidelines for the management of COVID-19 into practice.

Cited by 2 publications

References 4 publications

Dysregulated platelet function in patients with postacute sequelae of COVID-19

Dysregulated platelet function in patients with postacute sequelae of COVID-19

The intersection of coagulation activation and inflammation after injury: What you need to know

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