Abstract Number: PB/CO11
Meeting: ISTH 2020 Congress
Background: COVID-19 coagulopathy is characterized by abnormal levels of thrombo-inflammatory biomarkers, especially elevated D-dimer, which predicts need for critical care and death. In the general healthy population, these biomarkers are higher in Black than White individuals. Black individuals also have higher rates of COVID-19 infection and death
Aims: We hypothesized that the racial disparity in COVID-19 severity might relate partly to differences in thrombo-inflammatory response to infection. To address this, we studied correlations of thrombo-inflammatory biomarkers with D-dimer in healthy participants of the biracial REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Black-White differences in associations were studied.
Methods: We leveraged available data on 1068 participants with biomarkers measured. Linear regression was used to study the association of each biomarker with D-dimer, and interaction terms were used to identify racial differences in these associations. The University of Alabama at Birmingham IRB approved the study. NIH grant U01-NS041588 funds REGARDS.
Results: Table 1 shows that adverse levels of the majority of biomarkers were associated with higher D-dimer. Table 2 shows associations that differed significantly by race; the association between factor VIII with D-dimer was twice as large in Black compared to White participants (29% higher D-dimer per SD higher factor VIII in Blacks compared to 14% higher D-dimer per SD in Whites). In Black adults, IL-10 and sCD14 were associated with D-dimer, but this was not seen in White adults. In contrast, albumin negatively correlated with D-dimer in Whites only.
Conclusions: In this study, some biomarkers of COVID-19 coagulopathy were more strongly associated with D-dimer in Black compared with White individuals. This suggests a hypothesis that Black persons may have a more thrombo-inflammatory response to infection due to their different basal state of these biomarkers. Future research should examine the role of thrombo-inflammation in racial disparities in COVID-19.
To cite this abstract in AMA style:Kamin Mukaz D, Gergi M, Koh I, Zakai NA, Judd SE, Sholzberg M, Baumann Kreuziger L, Freeman K, Colovos C, Cushman M. Biomarkers of COVID-19 Coagulopathy and D-dimer in a Biracial Cohort Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/biomarkers-of-covid-19-coagulopathy-and-d-dimer-in-a-biracial-cohort-study/. Accessed May 18, 2021.
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