Abstract Number: PB0073
Meeting: ISTH 2022 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: Patients with SARS-CoV-2 infection have highly variable presentations, from asymptomatic disease to severe bilateral pneumonia. Hyperinflammatory host response leads to lung and endothelial severe injury. Matrix-metalloproteinases (MMPs) and their inhibitors (TIMPs), involved in tissue degradation and remodeling, are dysregulated in inflammatory processes and could play a role in the pathophysiology of COVID-19.
Aims: To evaluate the association of MMPs/TIMPs with SARS-CoV-2 infection evolution and its role as prognosis biomarkers.
Methods: Retrospective study of SARS-CoV-2 patients that required hospitalization between March and December 2020. Upon admission, plasma sample were collected. We measured MMPs (1, 2, 7, 9 and 10) with MAP Human MMP panel 2 (Luminex) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) with ELISA kit for TIMP-1 (R&D Systems). The primary outcome was all-cause death during hospitalization. Secondary endpoint included a composite of death, requirement of mechanical ventilation or intensive care unit (ICU) admission and venous/arterial thrombosis.
Results: We included 151 patients (mean age 62±14 years). Overall, 9.9% patients died during hospitalization, 17.9% required transfer to the ICU and 7.9% developed a thrombotic event, despite the use of antithrombotic therapy in 99% of the patients. Statistically significant but weak positive correlations (R < 0.4 in all cases) between MMPs/TIMP-1 and inflammatory biomarkers such as neutrophil count, CRP, Ferritin or IL-6 were stablished. In the multivariate analysis, MMP-10 was associated with the risk of death (odds ratio 6.05; 95% confidence interval, 1.80-20.36; p=0.004). Both, MMP-10 and TIMP-1 levels were independently associated with worse combined outcome (OR (95%CI) were 3.32 (1.41-7.83) and 4.38 (1.22 – 15.76) respectively). These OR were higher than those obtained for D-Dimer (OR 2.41 (95%CI: 1.05-5.57)).
Conclusion(s): Baseline MMP-10 and TIMP-1 levels are predictors of unfavorable outcome in hospitalized COVID-19 patients. Future studies should focus their use as potential therapeutic targets.
To cite this abstract in AMA style:
Marcos-Jubilar M, Panizo M, Alfonso-Piérola A, Orbe J, Alegre F, Argueta A, Troyas R, Del Pozo J, Lozano M, Páramo J, Lecumberri R. Matrix metalloproteinases are associated with poor prognosis in hospitalized patients with COVID-19 [abstract]. https://abstracts.isth.org/abstract/matrix-metalloproteinases-are-associated-with-poor-prognosis-in-hospitalized-patients-with-covid-19/. Accessed September 29, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/matrix-metalloproteinases-are-associated-with-poor-prognosis-in-hospitalized-patients-with-covid-19/