4.6 Article

Curative anticoagulation prevents endothelial lesion in COVID-19 patients

期刊

JOURNAL OF THROMBOSIS AND HAEMOSTASIS
卷 18, 期 9, 页码 2391-2399

出版社

ELSEVIER SCIENCE INC
DOI: 10.1111/jth.14968

关键词

circulating endothelial cells; coagulopathy; COVID-19; D-dimers; SARS-CoV-2

资金

  1. ANR SARCODO (Fondation de France)

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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 The 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 = .02), cough (P = .03), and pneumonia at computed tomography (CT) scan (P = .002) at admission. Prevalence of D-dimer >500 ng/mL was higher in COVID-19-positive patients (74.2% versus 43.3%;P = .007). No sign of disseminated intravascular coagulation were identified. Adding D-dimers >500 ng/mL to gender and pneumonia at CT scan in receiver operating characteristic curve analysis significantly increased area under the curve for COVID-19 diagnosis. COVID-19-positive patients had significantly more CECs at admission (P = .008) than COVID-19-negative ones. COVID-19-positive patients treated with curative anticoagulant prior to admission had fewer CECs (P = .02) than those without. Interestingly, patients treated with curative anticoagulation and angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers had even fewer CECs (P = .007). Conclusion Curative anticoagulation could prevent COVID-19-associated coagulopathy and endothelial lesion.

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