Dimitrios-Dorotheos Papadakis1, Marianna Politou2, Maria Kompoti3, Dimitrios Vagionas1, Eirini Kostakou1, Danai Theodoulou1, Evangelos Kaniaris1, Nikoletta Rovina1, George Panayiotakopoulos4, Stavros Dimopoulos5, Antonia Koutsoukou1, Ioannis Vasileiadis6. 1. Intensive Care Unit, 1 Department of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece. 2. Haematology Laboratory-Blood Bank, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece. 3. Thriassio General Hospital of Eleusis, Eleusis, Greece. 4. Pharmacology Laboratory, Medical School, Patras University, Rio, Greece. 5. 1 Critical Care Department, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece. 6. 1 Critical Care Department, National and Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece ioannisvmed@yahoo.gr ivasileiadis@med.uoa.gr.
Abstract
BACKGROUND/AIM: Multiple reports from all over the world link COVID-19 with endothelial/coagulation disorders as well as a dysregulated immune response. This study tested the hypothesis that immunostimulation will be greater in COVID-19 patients than in patients with H1N1 infection or bacterial sepsis. Also, whether an increase in immune stimulation will be accompanied by a more severely affected endothelium/coagulation system was examined. PATIENTS AND METHODS: Twenty-three septic patients, admitted in the Intensive Care Unit (ICU), were enrolled (9 with SARS-CoV-2, 5 with H1N1 pneumonia, 9 with bacterial sepsis). Myeloperoxidase (MPO) activity along with certain endothelial/coagulation factors were assessed on admission (time point 1) and at either improvement or deterioration (time point 2). RESULTS: MPO levels were significantly higher in COVID-19 patients compared to both other groups. Furthermore, in patients with COVID-19, vWF levels did not differ significantly, fVIII levels were lower while ADAMTS-13 activity was higher compared to patients with H1N1 pneumonia and bacterial sepsis (a trend in the latter). CONCLUSION: Increased immunostimulation was noted in COVID-19 patients compared to other septic patients; however, this was not accompanied by greater disturbance of the clotting system and/or more severe endothelial injury.
BACKGROUND/AIM: Multiple reports from all over the world link COVID-19 with endothelial/coagulation disorders as well as a dysregulated immune response. This study tested the hypothesis that immunostimulation will be greater in COVID-19 patients than in patients with H1N1 infection or bacterial sepsis. Also, whether an increase in immune stimulation will be accompanied by a more severely affected endothelium/coagulation system was examined. PATIENTS AND METHODS: Twenty-three septic patients, admitted in the Intensive Care Unit (ICU), were enrolled (9 with SARS-CoV-2, 5 with H1N1 pneumonia, 9 with bacterial sepsis). Myeloperoxidase (MPO) activity along with certain endothelial/coagulation factors were assessed on admission (time point 1) and at either improvement or deterioration (time point 2). RESULTS: MPO levels were significantly higher in COVID-19 patients compared to both other groups. Furthermore, in patients with COVID-19, vWF levels did not differ significantly, fVIII levels were lower while ADAMTS-13 activity was higher compared to patients with H1N1 pneumonia and bacterial sepsis (a trend in the latter). CONCLUSION: Increased immunostimulation was noted in COVID-19 patients compared to other septic patients; however, this was not accompanied by greater disturbance of the clotting system and/or more severe endothelial injury.
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