Curative anticoagulation prevents endothelial lesion in COVID‐19 patients

Khider, Lina; Gendron, Nicolas; Goudot, Guillaume; Chocron, Richard; Hauw‐Berlemont, Caroline; Cheng, Charles; Rivet, Nadia; Pere, Helene; Roffe, Ariel; Clerc, Sébastien; Lebeaux, David; Debuc, Benjamin; Veyer, David; Rance, Bastien; Gaussem, Pascale; Bertil, Sébastien; Badoual, Cécile; Juvin, Philippe; Planquette, Benjamin; Messas, Emmanuel; Sanchez, Olivier; Hulot, Jean‐Sébastien; Diehl, Jean‐Luc; Mirault, Tristan; Smadja, David M.

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.