Antonin Trimaille1,2, Jecko Thachil3, Benjamin Marchandot1, Anaïs Curtiaud1, Ian Leonard-Lorant4, Adrien Carmona1, Kensuke Matsushita1,2, Chisato Sato1,2, Laurent Sattler5, Lelia Grunebaum5, Yves Hansmann6, Samira Fafi-Kremer7, Laurence Jesel1,2, Mickaël Ohana4, Olivier Morel1,2. 1. Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, 67000 Strasbourg, France. 2. INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, 67000 Strasbourg, France. 3. Department of Haematology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. 4. Department of Radiology, Nouvel Hôpital Civil, Strasbourg University Hospital, 67000 Strasbourg, France. 5. Laboratory of Haematology, Thrombosis and Haemostasis Unit, Strasbourg University Hospital, 67000 Strasbourg, France. 6. Department of Infectious Diseases, Nouvel Hôpital Civil, Strasbourg University Hospital, 67000 Strasbourg, France. 7. Department of Virology, Nouvel Hôpital Civil, Strasbourg University Hospital, 67000 Strasbourg, France.
Abstract
BACKGROUND AND OBJECTIVE: Host defence mechanisms to counter virus infection include the activation of the broncho-alveolar haemostasis. Fibrin degradation products secondary to extravascular fibrin breakdown could contribute to the marked increase in D-Dimers during COVID-19. We sought to examine the prognostic value on lung injury of D-Dimers in non-critically ill COVID-19 patients without thrombotic events. METHODS: This study retrospectively analysed hospitalized COVID-19 patients classified according to a D-Dimers threshold following the COVID-19 associated haemostatic abnormalities (CAHA) classification at baseline and at peak (Stage 1: D-Dimers less than three-fold above normal; Stage 2: D-Dimers three- to six-fold above normal; Stage 3: D-Dimers six-fold above normal). The primary endpoint was the occurrence of critical lung injuries on chest computed tomography. The secondary outcome was the composite of in-hospital death or transfer to the intensive care unit (ICU). RESULTS: Among the 123 patients included, critical lung injuries were evidenced in 8 (11.9%) patients in Stage 1, 6 (20%) in Stage 2 and 15 (57.7%) in Stage 3 (p = 0.001). D-Dimers staging at peak was an independent predictor of critical lung injuries regardless of the inflammatory burden assessed by CRP levels (OR 2.70, 95% CI (1.50-4.86); p < 0.001) and was significantly associated with increased in-hospital death or ICU transfer (14.9 % in Stage 1, 50.0% in Stage 2 and 57.7% in Stage 3 (p < 0.001)). D-Dimers staging at peak was an independent predictor of in-hospital death or ICU transfer (OR 2.50, CI 95% (1.27-4.93); p = 0.008). CONCLUSIONS: In the absence of overt thrombotic events, D-Dimers quantification is a relevant marker of critical lung injuries and dismal patient outcome.
BACKGROUND AND OBJECTIVE: Host defence mechanisms to counter virus infection include the activation of the broncho-alveolar haemostasis. Fibrin degradation products secondary to extravascular fibrin breakdown could contribute to the marked increase in D-Dimers during COVID-19. We sought to examine the prognostic value on lung injury of D-Dimers in non-critically illCOVID-19patients without thrombotic events. METHODS: This study retrospectively analysed hospitalized COVID-19patients classified according to a D-Dimers threshold following the COVID-19 associated haemostatic abnormalities (CAHA) classification at baseline and at peak (Stage 1: D-Dimers less than three-fold above normal; Stage 2: D-Dimers three- to six-fold above normal; Stage 3: D-Dimers six-fold above normal). The primary endpoint was the occurrence of critical lung injuries on chest computed tomography. The secondary outcome was the composite of in-hospital death or transfer to the intensive care unit (ICU). RESULTS: Among the 123 patients included, critical lung injuries were evidenced in 8 (11.9%) patients in Stage 1, 6 (20%) in Stage 2 and 15 (57.7%) in Stage 3 (p = 0.001). D-Dimers staging at peak was an independent predictor of critical lung injuries regardless of the inflammatory burden assessed by CRP levels (OR 2.70, 95% CI (1.50-4.86); p < 0.001) and was significantly associated with increased in-hospital death or ICU transfer (14.9 % in Stage 1, 50.0% in Stage 2 and 57.7% in Stage 3 (p < 0.001)). D-Dimers staging at peak was an independent predictor of in-hospital death or ICU transfer (OR 2.50, CI 95% (1.27-4.93); p = 0.008). CONCLUSIONS: In the absence of overt thrombotic events, D-Dimers quantification is a relevant marker of critical lung injuries and dismal patient outcome.
Authors: Alexandre Godon; Zoé Durand; Lydiane Agier; Thomas Lecompte; François Mullier; Raphaël Marlu; Emmanuel de Maistre; Charles Tacquard; Jerrold H Levy; Anne Godier; Sophie Susen; Pierre Albaladejo Journal: Thromb Res Date: 2021-06-19 Impact factor: 3.944
Authors: Luis García de Guadiana-Romualdo; Daniel Morell-García; Emmanuel J Favaloro; Juan A Vílchez; Josep M Bauça; María J Alcaide Martín; Irene Gutiérrez Garcia; Patricia de la Hera Cagigal; José Manuel Egea-Caparrós; Sonia Pérez Sanmartín; José I Gutiérrez Revilla; Eloísa Urrechaga; Jose M Álamo; Ana M Hernando Holgado; María-Carmen Lorenzo-Lozano; Magdalena Canalda Campás; María A Juncos Tobarra; Cristian Morales-Indiano; Isabel Vírseda Chamorro; Yolanda Pastor Murcia; Laura Sahuquillo Frías; Laura Altimira Queral; Elisa Nuez-Zaragoza; Juan Adell Ruiz de León; Alicia Ruiz Ripa; Paloma Salas Gómez-Pablos; Iria Cebreiros López; Amaia Fernández Uriarte; Alex Larruzea; María L López Yepes; Natalia Sancho-Rodríguez; María C Zamorano Andrés; José Pedregosa Díaz; Luis Sáenz; Clara Esparza Del Valle; María C Baamonde Calzada; Sara García Muñoz; Marina Vera; Esther Martín Torres; Silvia Sánchez Fdez-Pacheco; Luis Vicente Gutiérrez; Laura Jiménez Añón; Alfonso Pérez Martínez; Aurelio Pons Castillo; Ruth González Tamayo; Jorge Férriz Vivancos; Olaia Rodríguez-Fraga; Vicens Díaz-Brito; Vicente Aguadero; M G García Arévalo; María Arnaldos Carrillo; Mercedes González Morales; María Núñez Gárate; Cristina Ruiz Iruela; Patricia Esteban Torrella; Martí Vila Pérez; Cristina Acevedo Alcaraz; Alfonso L Blázquez-Manzanera; Amparo Galán Ortega Journal: J Thromb Thrombolysis Date: 2021-07-16 Impact factor: 2.300