Abstract Number: PB0239
Meeting: ISTH 2021 Congress
Background: The main factors associated with disease severity in COVID-19 are age, sex, body weight, hypertension, and diabetes. Biomarkers of hemostatic activation have been shown to be independent predictors of disease severity in different populations of inpatients.
Aims: To evaluate whether biomarkers of hemostatic activation were associated with clinical outcomes in patients admitted to a field hospital, set up to provide initial care to patients in the early symptomatic phase of COVID-19.
Methods: Data and samples were obtained from June to September 2020. Laboratory evaluation included complete blood counts, PT, aPTT, fibrinogen, D-dimer, factor VIII activity, Von Willebrand Factor (VWF) (activity and antigen), C reactive protein (CRP) and P-selectin (ELISA). Patients were segregated by outcome, with clinical deterioration defined as need for ICU, mechanical ventilation, pulmonary embolism, deep vein thrombosis or death.
Results: In total 209 were enrolled in the study, of which 24 presented clinical deterioration (11.5%). Clinical data are described in table 1. No differences could be observed between patient subgroups regarding the presence of fever (63.2% vs. 62.5%), dry cough (75.1% vs. 87.5%) and dyspnea (65.9% vs. 54.2%) at admission. As main comorbidities, the groups presented chronic obstructive pulmonary disease (2.2% vs 8.3%), asthma (3.2% vs 4.2%), chronic heart failure (1.1% vs 8.3%), arterial hypertension (46% vs 41.7%) and diabetes (28.1% vs 33.3%) in comparing improved with clinical deterioration patients. Laboratory markers of hemostatic activation are shown in table 2. In general, it was verified a significant decrease in platelet number, and an increase in the parameters of aPTT, CRP, vWF antigen and ristocetin cofactor.
|Sex F/M||89 (48.1%) / 96 (51.9%)||10 (41.7%) / 14 (58.3%)|
|Mean Age ±SD||53.6 ± 14.0||58.1 ±13.6|
|BMI||30.3 ± 5.6||30.0 ± 5.2|
|Alveolar Infiltrate||76 (41.1%)||12 (50%)|
|Mean time of initial symptoms and RT-PCR exam (days)||5.7 ± 4||4.6 ± 2.8|
|Mean time symptoms to Hospitalization (days)||12.1 ± 5.7
||11.0 ± 5.0|
|Platelet Number (x103 cells/uL)||256 ± 108.1||203.8 ± 92.4||0.0426|
|CRP (mg/L)||64.2 ± 65.6||98.3 ± 90.9||0.0450|
|aPTT (seconds)||29 ± 10.0||33.7 ± 5.8||0.0084|
|vWF antigen (UI/dL)||333.2 ± 139.2||411.4 ± 106.4||0.0022|
|vWF ristocetin cofactor (UI/dL)||270 ± 111||324.4 ± 95.2||0.0032|
Conclusions: Our results demonstrate that hemostasis activation is associated with clinical deterioration even at the early phases of COVID-19.
Supported by FAPESP number 2016/1417-2. Approved by Ethics Research Committee of Unicamp.
To cite this abstract in AMA style:Huber S, Montalvão S, Martins S, da Silva L, Bacchin C, Santos N, Diaz T, Wroclawsk C, Filho C, de Paula E, Annichino-Bizzacchi J. Hemostastatic Alterations with Disease Severity in the Early Symptomatic Phase of COVID-19 [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/hemostastatic-alterations-with-disease-severity-in-the-early-symptomatic-phase-of-covid-19/. Accessed November 27, 2021.
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