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Platelet Reactivity and Coagulation Markers in Patients with COVID-19

INTRODUTION: COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and...

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Autores principales: Bertolin, Adriadne J., Dalçóquio, Talia F., Salsoso, Rocío, de M. Furtado, Remo H., Kalil-Filho, Roberto, Hajjar, Ludhmila A., Siciliano, Rinaldo F., Kallás, Esper G., Baracioli, Luciano M., Lima, Felipe G., Giraldez, Roberto R., Cavalheiro-Filho, Cyrillo, Vieira, Alexandra, Strunz, Célia M. C., Giugliano, Robert P., Tantry, Udaya S., Gurbel, Paul A., Nicolau, José C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176448/
https://www.ncbi.nlm.nih.gov/pubmed/34086266
http://dx.doi.org/10.1007/s12325-021-01803-w
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author Bertolin, Adriadne J.
Dalçóquio, Talia F.
Salsoso, Rocío
de M. Furtado, Remo H.
Kalil-Filho, Roberto
Hajjar, Ludhmila A.
Siciliano, Rinaldo F.
Kallás, Esper G.
Baracioli, Luciano M.
Lima, Felipe G.
Giraldez, Roberto R.
Cavalheiro-Filho, Cyrillo
Vieira, Alexandra
Strunz, Célia M. C.
Giugliano, Robert P.
Tantry, Udaya S.
Gurbel, Paul A.
Nicolau, José C.
author_facet Bertolin, Adriadne J.
Dalçóquio, Talia F.
Salsoso, Rocío
de M. Furtado, Remo H.
Kalil-Filho, Roberto
Hajjar, Ludhmila A.
Siciliano, Rinaldo F.
Kallás, Esper G.
Baracioli, Luciano M.
Lima, Felipe G.
Giraldez, Roberto R.
Cavalheiro-Filho, Cyrillo
Vieira, Alexandra
Strunz, Célia M. C.
Giugliano, Robert P.
Tantry, Udaya S.
Gurbel, Paul A.
Nicolau, José C.
author_sort Bertolin, Adriadne J.
collection PubMed
description INTRODUTION: COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls. METHODS: Observational, case control study that included patients with confirmed COVID-19 (COVID-19 group, n = 60) and healthy individuals matched by age and sex (control group, n = 60). Multiplate electrode aggregometry (MEA) tests were used to assess PR with adenosine diphosphate (MEA-ADP, low PR defined as < 53 AUC), arachidonic acid (MEA-ASPI, low PR < 86 AUC) and thrombin receptor-activating peptide 6 (MEA-TRAP, low PR < 97 AUC) in both groups. RESULTS: The rates of low PR with MEA-ADP were 27.5% in the COVID-19 group and 21.7% in the control group (OR = 1.60, p = 0.20); with MEA-ASPI, the rates were, respectively, 37.5% and 22.5% (OR = 3.67, p < 0.001); and with MEA-TRAP, the incidences were 48.5% and 18.8%, respectively (OR = 9.58, p < 0.001). Levels of d-dimer, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) were higher in the COVID-19 group in comparison with the control group (all p < 0.05). Thromboelastometry was utilized in a subgroup of patients and showed a hypercoagulable state in the COVID-19 group. CONCLUSION: Patients hospitalized with non-severe COVID-19 had lower PR compared to healthy controls, despite having higher levels of d-dimer, fibrinogen, and PAI-1, and hypercoagulability by thromboelastometry. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT04447131. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01803-w.
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spelling pubmed-81764482021-06-04 Platelet Reactivity and Coagulation Markers in Patients with COVID-19 Bertolin, Adriadne J. Dalçóquio, Talia F. Salsoso, Rocío de M. Furtado, Remo H. Kalil-Filho, Roberto Hajjar, Ludhmila A. Siciliano, Rinaldo F. Kallás, Esper G. Baracioli, Luciano M. Lima, Felipe G. Giraldez, Roberto R. Cavalheiro-Filho, Cyrillo Vieira, Alexandra Strunz, Célia M. C. Giugliano, Robert P. Tantry, Udaya S. Gurbel, Paul A. Nicolau, José C. Adv Ther Original Research INTRODUTION: COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls. METHODS: Observational, case control study that included patients with confirmed COVID-19 (COVID-19 group, n = 60) and healthy individuals matched by age and sex (control group, n = 60). Multiplate electrode aggregometry (MEA) tests were used to assess PR with adenosine diphosphate (MEA-ADP, low PR defined as < 53 AUC), arachidonic acid (MEA-ASPI, low PR < 86 AUC) and thrombin receptor-activating peptide 6 (MEA-TRAP, low PR < 97 AUC) in both groups. RESULTS: The rates of low PR with MEA-ADP were 27.5% in the COVID-19 group and 21.7% in the control group (OR = 1.60, p = 0.20); with MEA-ASPI, the rates were, respectively, 37.5% and 22.5% (OR = 3.67, p < 0.001); and with MEA-TRAP, the incidences were 48.5% and 18.8%, respectively (OR = 9.58, p < 0.001). Levels of d-dimer, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) were higher in the COVID-19 group in comparison with the control group (all p < 0.05). Thromboelastometry was utilized in a subgroup of patients and showed a hypercoagulable state in the COVID-19 group. CONCLUSION: Patients hospitalized with non-severe COVID-19 had lower PR compared to healthy controls, despite having higher levels of d-dimer, fibrinogen, and PAI-1, and hypercoagulability by thromboelastometry. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT04447131. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01803-w. Springer Healthcare 2021-06-04 2021 /pmc/articles/PMC8176448/ /pubmed/34086266 http://dx.doi.org/10.1007/s12325-021-01803-w Text en © The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Research
Bertolin, Adriadne J.
Dalçóquio, Talia F.
Salsoso, Rocío
de M. Furtado, Remo H.
Kalil-Filho, Roberto
Hajjar, Ludhmila A.
Siciliano, Rinaldo F.
Kallás, Esper G.
Baracioli, Luciano M.
Lima, Felipe G.
Giraldez, Roberto R.
Cavalheiro-Filho, Cyrillo
Vieira, Alexandra
Strunz, Célia M. C.
Giugliano, Robert P.
Tantry, Udaya S.
Gurbel, Paul A.
Nicolau, José C.
Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title_full Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title_fullStr Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title_full_unstemmed Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title_short Platelet Reactivity and Coagulation Markers in Patients with COVID-19
title_sort platelet reactivity and coagulation markers in patients with covid-19
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176448/
https://www.ncbi.nlm.nih.gov/pubmed/34086266
http://dx.doi.org/10.1007/s12325-021-01803-w
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