Curative anticoagulation prevents endothelial lesion in COVID‐19 patients
ISTH Academy. Smadja D. 06/18/20; 307345
Journal Abstract
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.
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.
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