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. 2024 Jun 10:11:1399335.
doi: 10.3389/fmed.2024.1399335. eCollection 2024.

Combined coagulation and inflammation markers as predictors of venous thrombo-embolism and death in COVID-19

Jaja Zhu #  1   2 , Raïda Bouzid #  3 , Benoît Travert  4 , Guillaume Géri  5 , Yves Cohen  6 , Adrien Picod  6 , Nicholas Heming  7   8   9   10 , Martin Rottman  11   12 , Bérangère Joly-Laffargue  3   13   14 , Agnès Veyradier  3   13   14 , Claude Capron  1   15 , Paul Coppo  3   16   17
Affiliations

Combined coagulation and inflammation markers as predictors of venous thrombo-embolism and death in COVID-19

Jaja Zhu et al. Front Med (Lausanne). .

Abstract

Background: The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively.

Objectives: We investigated the role of prognostic factors from the coagulation or inflammatory pathways to better understand the outcome of the disease.

Methods: For this, we prospectively studied 167 SARS-CoV-2-positive patients from admission in intensive care units (ICU) or emergency departments from four academic hospitals over a 14-month period. Besides standard biology, we assessed serum concentrations of inflammatory markers, coagulation factors and peripheral blood cells immunophenotyping.

Results: Thirty-nine patients (23.3%) developed VT and 30 patients (18%) died. By univariate analysis, C-reactive protein (CRP) level > 150 mg/L, interleukin-6 (IL-6) ≥ 20 pg/mL, D-dimers > 1,500 μg/L, ADAMTS13 activity ≤ 50%, Von.

Conclusion: A combination of coagulation and inflammatory markers can refine the prognostication of severe outcome in COVID-19, and could be useful for the initial evaluation of other types of viral infection.

Keywords: ADAMTS13; C-reactive protein; COVID-19; interleukin-6; prognosis; thrombosis; von Willebrand factor.

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Conflict of interest statement

PC was member of the Clinical Advisory Board for Alexion, Sanofi, Takeda, and Janssen. AV had participated to Advisory boards for Sanofi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) Demographic data; (B) main severe outcomes (thrombo-embolic events and survival) according to sex. VT, venous or pulmonary thrombosis.
FIGURE 2
FIGURE 2
(A) C-reactive protein, (A) interleukin-6 (IL-6), (B) ADAMTS13 activity, (C) VWF:CB at the baseline between patients with (red bars) or without (blue bars) venous and pulmonary thrombosis (VT); (D) interleukin-6 (IL-6), (E) ADAMTS13 activity, (F) VWF:Ag, at the baseline between ICU patients (red bars) vs. non ICU patients (blue bars); (G) Interleukin-6 (IL-6), (H) ADAMTS13 activity, (I) VWF:CB at baseline between survivors (blue bars) and non-survivors (red bars). *p < 0.05; **p < <0.01; ***p < 0.001.
See this image and copyright information in PMC

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