Author: Rauch, Antoine; Labreuche, Julien; Lassalle, Fanny; Goutay, Julien; Caplan, Morgan; Charbonnier, Leslie; Rohn, Aurelien; Jeanpierre, Emmanuelle; Dupont, Annabelle; Duhamel, Alain; Faure, Karine; Lambert, Marc; Kipnis, Eric; Garrigue, Delphine; Lenting, Peter J.; Poissy, Julien; Susen, Sophie
Title: Coagulation biomarkers are independent predictors of increased oxygen requirements in COVIDâ€19 Cord-id: 9m3e07sc Document date: 2020_8_17
ID: 9m3e07sc
Snippet: BACKGROUND: Hypercoagulability seems to contribute to SARSâ€CoVâ€2 pneumonia pathogenesis. However, age and metabolic syndrome are potential cofounders when assessing the value of coagulation biomarkers prediction of COVIDâ€19 outcomes. We assessed whether coagulation biomarkers, including FVIII and VWF levels, measured at time of admission were predictive of COVIDâ€19 adverse outcomes irrespective of age and major comorbidities associated with metabolic syndrome. METHODS: Blood was sampled
Document: BACKGROUND: Hypercoagulability seems to contribute to SARSâ€CoVâ€2 pneumonia pathogenesis. However, age and metabolic syndrome are potential cofounders when assessing the value of coagulation biomarkers prediction of COVIDâ€19 outcomes. We assessed whether coagulation biomarkers, including FVIII and VWF levels, measured at time of admission were predictive of COVIDâ€19 adverse outcomes irrespective of age and major comorbidities associated with metabolic syndrome. METHODS: Blood was sampled at admission in 243 adult COVIDâ€19 patients for analysis of coagulation biomarkers including FVIII and VWF on plateletâ€poor plasma. The association between baseline CRP, aPTT ratio, PT ratio, Dâ€dimers, fibrinogen, FVIII, VWF:Ag and FVIII/VWF:Ag ratio levels and adverse outcomes (increased oxygen requirements, thrombosis and death at dayâ€30) was assessed by regression analysis after adjustment on age, sex, body mass index, diabetes and hypertension. RESULTS: In univariable regression analysis increased CRP (SHR, 1.68; 95%CI, 1.26 to 2.23), increased fibrinogen (SHR, 1.32; 95% CI, 1.04 to 1.68) and decreased FVIII/VWF:Ag ratio (SHR, 0.70 ; 95% CI, 0.52â€0.96) levels at admission were significantly associated with the risk of increased oxygen requirement during followâ€up. Leucocytes (SHR, 1.36; 95%CI, 1.04 to 1.76), platelets (SHR,1.71; 95%CI, 1.11 to 2.62), Dâ€dimers (SHR, 2.48; 95%CI, 1.66 to 3.78), FVIII (SHR, 1.78; 95%CI, 1.17 to 2.68) were associated with early onset of thrombosis after admission. After adjustment for age, sex, BMI, hypertension and diabetes, these associations were not modified. CONCLUSION: Coagulation biomarkers are early and independent predictors of increased oxygen requirement in COVIDâ€19 patients.
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