Abstract Number: PB0053
Meeting: ISTH 2022 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: Venovenous extracorporeal membrane oxygenation (ECMO) is a cornerstone in the management of severe acute respiratory distress syndrome (ARDS) and causes hemostatic system activation and inflammation. COVID-19 is known to cause thromboinflammation. Elucidation of the underlying pathomechanisms is of great importance.
Aims: To evaluate markers of NET formation in COVID-19 and non-COVID-19 associated ARDS and ECMO and to explore the role of different NET parameters as markers of inflammation and coagulopathy.
Methods: We studied 31 adult COVID-19 patients and 23 adult non-COVID-19 patients with severe ARDS requiring ECMO and 47 sex-and age-matched healthy controls. Blood was collected at time point A (ECMO day 0-4) and at time point B (ECMO day 7-17).
Citrullinated histone H3 (citH3), cell-free DNA (cfDNA), and plasma myeloperoxidase DNA (mpoDNA), as well as d-Dimer, were evaluated.
Values are given as median (25th, 75th percentile). Statistical testing was performed using unpaired t-tests of logarithmized parameters.
Results: COVID-19 and non-COVID-19 patients exhibited significantly higher levels of citH3, cfDNA, and mpoDNA than healthy controls (Table 1). Levels of citH3 decreased significantly from time point A to B in COVID-19 patients. No comparable effect was identified for cfDNA and mpoDNA (Table 1). In non-COVID-19 patients, no differences in levels of citH3, cfDNA, and mpoDNA were found between timepoints A and B (Table 1).
d-Dimer increased from time point A to timepoint B in both groups (Table 1).
Conclusion(s): NET formation is comparably increased in patients on ECMO because of COVID-19 and non-COVID-19 ARDS. Markers of NET formation could add information on immunothrombosis and the complex interplay of coagulation and inflammation in the context of ECMO.
Figure 1
Levels of citrullinated histone H3, cell-free DNA, myeloperoxidase DNA, and d-Dimer in COVID-19 and non-COVID-19 ECMO patients and in healthy controls
Table 1
Levels of citrullinated histone H3, cell-free DNA, myeloperoxidase DNA, and d-Dimer in COVID-19 and non-COVID-19 ECMO patients and in healthy controls
To cite this abstract in AMA style:
Buchtele N, Kollars M, Burgmann H, Kyrle P, Staudinger T, Eichinger S, Traby L. NET formation in patients with COVID-19 and non-COVID-19 ARDS on venovenous ECMO [abstract]. https://abstracts.isth.org/abstract/net-formation-in-patients-with-covid-19-and-non-covid-19-ards-on-venovenous-ecmo/. Accessed September 24, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/net-formation-in-patients-with-covid-19-and-non-covid-19-ards-on-venovenous-ecmo/