Persisting Endothelial Cell Activation and Hypercoagulability after COVID-19 Recovery—The Prospective Observational ROADMAP-Post COVID-19 Study
Article 2022 en
Authors
GG
Grigoris Gerotziafas
PD
Patrick Van Dreden
TS
Theodoros Ν. Sergentanis
Abstract
1 min read
Background. Hypercoagulable state and endothelial cell activation are common alterations in patients with COVID-19. Nevertheless, the hypothesis of persistent hypercoagulability and endothelial cell activation following recovery from COVID-19 remains an unresolved issue. Objectives. To investigate the persistence of endothelial cell activation and hypercoagulability after recovery from COVID-19. Patients/Methods. COVID-19 survivors (n = 208) and 30 healthy individuals were enrolled in this study. The following biomarkers were measured: procoagulant phospholipid-dependent clotting time (PPL-ct), D-Dimer, fibrin monomers (FM), free Tissue factor pathway inhibitor (free-TFP)I, heparinase, and soluble thrombomodulin (sTM). Antibodies against SARS-CoV-2 (IgG and IgA) were also measured. Results. The median interval between symptom onset and screening for SARS-CoV-2 antibodies was 62 days (IQR = 22 days). Survivors showed significantly higher levels of D-Dimers, FM, TFPI, and heparanase as compared to that of the control group. Survivors had significantly shorter PPL-ct. Elevated D-dimer was associated with older age. Elevated FM was associated with female gender. Elevated heparanase was independently associated with male gender. Decreased Procoag-PPL clotting time was associated with female gender. One out of four of COVID-19 survivors showed increase at least one biomarker of endothelial cell activation or hypercoagulability. Conclusions. Two months after onset of COVID-19, a significant activation of endothelial cells and in vivo thrombin generation persists in at least one out of four survivors of COVID-19. The clinical relevance of these biomarkers in the diagnosis and follow-up of patients with long COVID-19 merits to be evaluated in a prospective clinical study.
Grigoris Gerotziafas, Patrick Van Dreden, Douglas D. Fraser, Guillaume Voiriot, Maitray A. Patel, Mark Daley, Alexandre Elabbadi, Aurélie Rousseau, Yannis Prassas, Matthieu Turpin, Marina Marchetti, Loula Papageorgiou, Evangelos Terpos, Meletios A Dimopoulos, Anna Falanga, Jawed Fareed, Muriel Fartoukh, Ismaı̈l Elalamy
Patrick Van Dreden, Douglas D. Fraser, Guillaume Voiriot, Aurélie Rousseau, Ismaı̈l Elalamy, Ioannis Prassas, Evangelos Terpos, Meletios A Dimopoulos, Matthieu Grussé, Grigoris Gerotziafas
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