新冠肺炎康复后内皮细胞持续激活和高凝性——新冠肺炎后ROADM的前瞻性观察研究

IF 0.9 Q4 HEMATOLOGY Hemato Pub Date : 2022-01-26 DOI:10.3390/hemato3010010
G. Gerotziafas, P. Van Dreden, T. Sergentanis, M. Politou, A. Rousseau, Matthieu Grusse, M. Sabbah, I. Elalamy, V. Pappa, Tina Skourti, T. Bagratuni, I. Ntanasis-Stathopoulos, E. Korompoki, S. Labropoulou, M. Dimopoulos, E. Terpos
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引用次数: 4

摘要

背景高凝状态和内皮细胞活化是新冠肺炎患者常见的改变。尽管如此,新冠肺炎康复后持续高凝状态和内皮细胞活化的假设仍然是一个悬而未决的问题。目标。研究新冠肺炎康复后内皮细胞活化和高凝状态的持续性。患者/方法。新冠肺炎幸存者(n=208)和30名健康个体参与了这项研究。测量了以下生物标志物:促凝血磷脂依赖性凝血时间(PPL-ct)、D-二聚体、纤维蛋白单体(FM)、游离组织因子途径抑制剂(游离TFP)I、肝素酶和可溶性血栓调节蛋白(sTM)。还测量了针对严重急性呼吸系统综合征冠状病毒2型的抗体(IgG和IgA)。后果症状出现和严重急性呼吸系统综合征冠状病毒2型抗体筛查之间的中位间隔时间为62天(IQR=22天)。与对照组相比,幸存者的D-二聚体、FM、TFPI和乙酰肝素酶水平显著升高。幸存者的PPL ct明显缩短。D-二聚体升高与年龄增大有关。FM升高与女性有关。乙酰肝素酶升高与男性独立相关。Procoag PPL凝血时间缩短与女性有关。四分之一的新冠肺炎幸存者显示,至少一种内皮细胞活化或高凝状态的生物标志物增加。结论。新冠肺炎发病两个月后,至少四分之一的新冠肺炎幸存者的内皮细胞和体内凝血酶生成持续显著激活。这些生物标志物在长期新冠肺炎患者诊断和随访中的临床相关性值得在前瞻性临床研究中评估。
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Persisting Endothelial Cell Activation and Hypercoagulability after COVID-19 Recovery—The Prospective Observational ROADMAP-Post COVID-19 Study
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.
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