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Comparison of the coagulopathies associated with COVID‐19 and sepsis

BACKGROUND: Coronavirus disease 2019 (COVID‐19) is associated with activation of coagulation that mainly presents as thrombosis. Sepsis is also associated with activation of coagulation that mainly presents as disseminated intravascular coagulation. Many studies have reported increased levels of pla...

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Autores principales: Campbell, Robert A., Hisada, Yohei, Denorme, Frederik, Grover, Steven P., Bouck, Emma G., Middleton, Elizabeth A., Wolberg, Alisa S., Rondina, Matthew T., Mackman, Nigel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131194/
https://www.ncbi.nlm.nih.gov/pubmed/34027292
http://dx.doi.org/10.1002/rth2.12525
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author Campbell, Robert A.
Hisada, Yohei
Denorme, Frederik
Grover, Steven P.
Bouck, Emma G.
Middleton, Elizabeth A.
Wolberg, Alisa S.
Rondina, Matthew T.
Mackman, Nigel
author_facet Campbell, Robert A.
Hisada, Yohei
Denorme, Frederik
Grover, Steven P.
Bouck, Emma G.
Middleton, Elizabeth A.
Wolberg, Alisa S.
Rondina, Matthew T.
Mackman, Nigel
author_sort Campbell, Robert A.
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID‐19) is associated with activation of coagulation that mainly presents as thrombosis. Sepsis is also associated with activation of coagulation that mainly presents as disseminated intravascular coagulation. Many studies have reported increased levels of plasma d‐dimer in patients with COVID‐19 that is associated with severity, thrombosis, and mortality. OBJECTIVES: The aim of this study was to compare levels of circulating extracellular vesicle tissue factor (EVTF) activity and active plasminogen activator inhibitor 1 (PAI‐1) in plasma from patients with COVID‐19 or sepsis. METHODS: We measured levels of d‐dimer, EVTF activity, and active PAI‐1 in plasma samples from patients with COVID‐19 (intensive care unit [ICU], N = 15; and non‐ICU, N = 20) and patients with sepsis (N = 35). RESULTS: Patients with COVID‐19 had significantly higher levels of d‐dimer, EVTF activity, and active PAI‐1 compared with healthy controls. Patients with sepsis had significantly higher levels of d‐dimer and EVTF activity compared with healthy controls. Levels of d‐dimer were significantly lower in patients with COVID‐19 compared with patients with sepsis. Levels of EVTF activity were significantly higher in ICU patients with COVID‐19 compared with patients with sepsis. Levels of active PAI‐1 were significantly higher in patients with COVID‐19 compared with patients with sepsis. CONCLUSIONS: High levels of both EVTF activity and active PAI‐1 may promote thrombosis in patients with COVID‐19 due to simultaneous activation of coagulation and inhibition of fibrinolysis. The high levels of active PAI‐1 in patients with COVID‐19 may limit plasmin degradation of crosslinked fibrin and the release of d‐dimer. This may explain the lower levels of D‐dimer in patients with COVID‐19 compared with patients with sepsis.
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spelling pubmed-81311942021-05-21 Comparison of the coagulopathies associated with COVID‐19 and sepsis Campbell, Robert A. Hisada, Yohei Denorme, Frederik Grover, Steven P. Bouck, Emma G. Middleton, Elizabeth A. Wolberg, Alisa S. Rondina, Matthew T. Mackman, Nigel Res Pract Thromb Haemost Brief Reports BACKGROUND: Coronavirus disease 2019 (COVID‐19) is associated with activation of coagulation that mainly presents as thrombosis. Sepsis is also associated with activation of coagulation that mainly presents as disseminated intravascular coagulation. Many studies have reported increased levels of plasma d‐dimer in patients with COVID‐19 that is associated with severity, thrombosis, and mortality. OBJECTIVES: The aim of this study was to compare levels of circulating extracellular vesicle tissue factor (EVTF) activity and active plasminogen activator inhibitor 1 (PAI‐1) in plasma from patients with COVID‐19 or sepsis. METHODS: We measured levels of d‐dimer, EVTF activity, and active PAI‐1 in plasma samples from patients with COVID‐19 (intensive care unit [ICU], N = 15; and non‐ICU, N = 20) and patients with sepsis (N = 35). RESULTS: Patients with COVID‐19 had significantly higher levels of d‐dimer, EVTF activity, and active PAI‐1 compared with healthy controls. Patients with sepsis had significantly higher levels of d‐dimer and EVTF activity compared with healthy controls. Levels of d‐dimer were significantly lower in patients with COVID‐19 compared with patients with sepsis. Levels of EVTF activity were significantly higher in ICU patients with COVID‐19 compared with patients with sepsis. Levels of active PAI‐1 were significantly higher in patients with COVID‐19 compared with patients with sepsis. CONCLUSIONS: High levels of both EVTF activity and active PAI‐1 may promote thrombosis in patients with COVID‐19 due to simultaneous activation of coagulation and inhibition of fibrinolysis. The high levels of active PAI‐1 in patients with COVID‐19 may limit plasmin degradation of crosslinked fibrin and the release of d‐dimer. This may explain the lower levels of D‐dimer in patients with COVID‐19 compared with patients with sepsis. John Wiley and Sons Inc. 2021-05-18 /pmc/articles/PMC8131194/ /pubmed/34027292 http://dx.doi.org/10.1002/rth2.12525 Text en © 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Brief Reports
Campbell, Robert A.
Hisada, Yohei
Denorme, Frederik
Grover, Steven P.
Bouck, Emma G.
Middleton, Elizabeth A.
Wolberg, Alisa S.
Rondina, Matthew T.
Mackman, Nigel
Comparison of the coagulopathies associated with COVID‐19 and sepsis
title Comparison of the coagulopathies associated with COVID‐19 and sepsis
title_full Comparison of the coagulopathies associated with COVID‐19 and sepsis
title_fullStr Comparison of the coagulopathies associated with COVID‐19 and sepsis
title_full_unstemmed Comparison of the coagulopathies associated with COVID‐19 and sepsis
title_short Comparison of the coagulopathies associated with COVID‐19 and sepsis
title_sort comparison of the coagulopathies associated with covid‐19 and sepsis
topic Brief Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8131194/
https://www.ncbi.nlm.nih.gov/pubmed/34027292
http://dx.doi.org/10.1002/rth2.12525
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