Retrospective Analyses Associate Hemostasis Activation Biomarkers With Poor Outcomes in Patients With COVID-19

Abstract

Objectives Patients with coronavirus disease 2019 (COVID-19) have thromboembolic complications. Assessment of coagulation and other markers could be useful to understand their coagulopathy. Methods We performed a retrospective study of inflammatory and coagulation parameters, including prothrombin fragment 1.2 (PF1.2), thrombin-antithrombin complexes (TATs), fibrin monomers, and D-dimer, in hospitalized patients with COVID-19. We compared the markers in patients with thrombosis, admission to the intensive care unit (ICU), and poor outcome. Results Of the 81 patients, 9 (11%) experienced an acute thrombotic event (4 with pulmonary embolism, 3 with venous thrombosis, and 2 with stroke). PF1.2 was elevated in 32 (39%) patients, TATs in 54 (67%), fibrin monomers in 49 (60%), and D-dimer in 76 (94%). Statistically significant elevation in PF1.2 and TATs was seen in patients admitted to the ICU, while D-dimer and fibrin monomers were significantly elevated in patients with poor outcomes. The presence of multiple abnormal coagulation parameters was associated with ICU admission. Other parameters with statistically significant results included abnormal WBC counts and elevated C-reactive protein, which were associated with ICU admission and poor outcomes. Conclusions Our data demonstrate that abnormalities of biomarkers of hemostasis activation and inflammatory markers are associated with poor outcomes in patients with COVID-19.

Assessment of Coagulation and Hemostasis Biomarkers in a Subset of Patients With Chronic Cardiovascular Disease

“… 8 , 22 In our institution, the MOCHA panel in patients with COVID-19 showed that elevation in PF1.2 and TAT was associated with admission to the ICU, while D-dimer and fibrin monomers were increased in patients with poor outcomes. 14 Clinicians find value in the panel and its interpretation, as evidenced by the continued ordering of the panel for patients with cardiac conditions, including use of repeated measures. Though, it was not clear from our review of charts what triggers physicians to repeat testing in some patients but not others.…”

“…We have used the panel to study patients with stroke 13 and during the SARS-CoV2 pandemic. 14 The great majority of the MOCHA panel results from patients from the cardiology service are abnormal and the 4 conditions for which they are ordered include presence of heart assist devices, cardiomyopathies, atrial fibrillation, and intracardiac thrombosis. The objective of this study was to identify the variations present in MOCHA panel parameters for the above 4 conditions and perform a correlation with anticoagulation treatment.…”

Aspectos Epidemiológicos Sobre Covid-19 E a Relação Com Trombose Venosa Em Tempos De Pandemia: Uma Revisão De Literatura

“…Outros autores também verificaram a alta concentração do D-dímero em pacientes com COVID-19 e TV (PELLEGRINE et al, 2021;KERBIKOV et al, 2020;MOTAGANAHALLI et al, 2021). Outros resultados estatisticamente significativos incluem contagens de leucócitos anormais e proteína C reativa elevada, associados com admissão dos pacientes na UTI (MOOSAVI et al, 2020;POILLON et al, 2020). Bem como, a elevada taxa de enzimas hepáticas, do nível sérico de lactato desidrogenase (LDH) de acordo com os estudos de Motaganahalli et al (2021)…”

Could Daily Monitoring of Fibrin Related Markers Help Suspect a Thrombotic Event in COVID-19 Patients? A Prospective Pilot Study

“…1 for each patient. The maximal FRM levels (medians) observed before censoring (TE, death, ICU discharge or end of study period) were higher in patients diagnosed with a TE than in patients who were not: 20,000 (IQR: 7,610–20,000) versus 3710 ng/mL (2,825–6,265) for D-dimers ( p = 0.009, Mann-Whitney U test); 139 (8–150) versus 10 μg/mL 4 5 6 7 8 9 10 11 12 13 14 15 16 for FM ( p = 0.05, Mann-Whitney U test). We arbitrarily defined peak levels as follows: above 15,000 ng/mL or 100 μg/mL for D-dimers and FM respectively.…”

“… 10 To the best of our knowledge, there are few available data on FM in COVID-19 patients. 11 12 We therefore undertook a prospective observational exploratory monocentre study to get some insight as to whether their serial monitoring might help suspect an on-going thrombosis.…”