Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm?
| العنوان: | Thrombogenicity markers for early diagnosis and prognosis in COVID-19: a change from the current paradigm? |
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| المؤلفون: | Paul A. Gurbel, Udaya S. Tantry, Kevin P. Bliden, Jerrold H. Levy, Nicole Rapista, Christophe Jerjian, Naval Walia, Alastair Cho |
| المصدر: | Blood Coagulation & Fibrinolysis |
| بيانات النشر: | Lippincott Williams & Wilkins, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Organ Dysfunction Scores, Comorbidity, COVID-19 Testing, Medicine, Thrombophilia, Myocardial infarction, Prospective Studies, Prospective cohort study, Stroke, Aged, 80 and over, medicine.diagnostic_test, Hematology, General Medicine, Middle Aged, Prognosis, Thrombelastography, Hospitalization, Treatment Outcome, Cardiovascular Diseases, SOFA score, Female, Fibrin Clot Lysis Time, Adult, medicine.medical_specialty, Thrombogenicity, Hyperlipidemias, White People, Internal medicine, Diabetes Mellitus, Humans, Obesity, African--Americans, Aged, Fibrin, L-Lactate Dehydrogenase, business.industry, SARS-CoV-2, sequential organ failure assessment score, COVID-19, Fibrinogen, thromboelastography, Odds ratio, Original Articles, medicine.disease, Thromboelastography, Black or African American, Early Diagnosis, platelet fibrin clot strength, business, Biomarkers |
| الوصف: | Standard biomarkers have been widely used for COVID-19 diagnosis and prognosis. We hypothesize that thrombogenicity metrics measured by thromboelastography will provide better diagnostic and prognostic utility versus standard biomarkers in COVID-19 positive patients. In this observational prospective study, we included 119 hospitalized COVID-19 positive patients and 15 COVID-19 negative patients. On admission, we measured standard biomarkers and thrombogenicity using a novel thromboelastography assay (TEG-6s). In-hospital all-cause death and thrombotic occurrences (thromboembolism, myocardial infarction and stroke) were recorded. Most COVID-19 patients were African--Americans (68%). COVID-19 patients versus COVID-19 negative patients had higher platelet-fibrin clot strength (P-FCS), fibrin clot strength (FCS) and functional fibrinogen level (FLEV) (Pâ≤â0.003 for all). The presence of high TEG-6âs metrics better discriminated COVID-19 positive from negative patients. COVID-19 positive patients with sequential organ failure assessment (SOFA) score at least 3 had higher P-FCS, FCS and FLEV than patients with scores less than 3 (Pâ≤â0.001 for all comparisons). By multivariate analysis, the in-hospital composite endpoint occurrence of death and thrombotic events was independently associated with SOFA score more than 3 [odds ratio (OR)â=â2.9, Pâ=â0.03], diabetes (ORâ=â3.3, Pâ=â0.02) and FCSâ>â40âmm (ORâ=â3.4, Pâ=â0.02). This largest observational study suggested the early diagnostic and prognostic utility of thromboelastography to identify COVID-19 and should be considered hypothesis generating. Our results also support the recent FDA guidance regarding the importance of measurement of whole blood viscoelastic properties in COVID-19 patients. Our findings are consistent with the observation of higher hospitalization rates and poorer outcomes for African--Americans with COVID-19. |
| اللغة: | English |
| تدمد: | 1473-5733 0957-5235 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c50d87ded7123183d2e8e337e49a6278Test http://europepmc.org/articles/PMC8630843Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c50d87ded7123183d2e8e337e49a6278 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14735733 09575235 |
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