PB0068 - Comparative profiles of routine and specialized biomarkers of coagulopathy and endotheliopathy in moderate and severe COVID-19 disease : a prospective observational study

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

GB

Giovanni Bousquet

Assistant
Assistance Publique des Hôpitaux de Marseille
Marseille, Provence-Alpes-Cote d'Azur, France

Presenting Author(s)

RL

Romaric Lacroix, PharmD PhD

PharmD. PhD. - Professor of Immunology and Hematology
Aix-Marseille Univ, APHM, INSERM, INRAE, C2VN, Laboratory of Hematology and Vascular Biology, University Hospital La Conception, Marseille, France
Marseille, Provence-Alpes-Cote d'Azur, France

Co-Author(s)

LP

Laurie Pahus

MCU-AH
APHM
Marseille, Provence-Alpes-Cote d'Azur, France
SV

Sabine Valera

Nurse
APHM
Marseille, Provence-Alpes-Cote d'Azur, France
LA

Laurent Arnaud

Ingenior
APHM
Marseille, Provence-Alpes-Cote d'Azur, France
EA

Evelyne Abdili

Engineer
Biogenopole, APHM
Marseille, Provence-Alpes-Cote d'Azur, France
FD

Françoise Dignat-Georges

Professor
APHM
Marseille, Provence-Alpes-Cote d'Azur, France
NH

Nathalie Hezard

Dr
APHM
Marseille, Provence-Alpes-Cote d'Azur, France
LP

Laurent Papazian

MD - Professor of Intensive Care Medicine
Aix-Marseille Univ, APHM, Medical Intensive Care Unit, North Hospital-Center for Studies and Research on Health Services and Quality of Life, EA3279 Research Unit, Marseille , France
Marseille, Provence-Alpes-Cote d'Azur, France
SH

Sami Hraiech

MD-Assistant Professor
Aix-Marseille Univ, APHM, Medical Intensive Care Unit, North Hospital - Center for Studies and Research on Health Services and Quality of Life, EA3279 Research Unit, Marseille, France
Marseille, Provence-Alpes-Cote d'Azur, France
JF

Jean-Marie Forel

MD
Aix-Marseille Univ, APHM, Medical Intensive Care Unit, North Hospital -Center for Studies and Research on Health Services and Quality of Life, EA3279 Research Unit, Marseille, France
Marseille, Provence-Alpes-Cote d'Azur, France
PM

Pierre-Emmanuel Morange, MD, PhD

MD, PhD
Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, Hôpitaux de Marseille, Marseille, France
Marseille, Provence-Alpes-Cote d'Azur, France
CG

Christophe Guervilly

MD
Aix-Marseille Univ, APHM, Medical Intensive Care Unit, North Hospital - Center for Studies and Research on Health Services and Quality of Life, EA3279 Research Unit, Marseille, France
Marseille, Provence-Alpes-Cote d'Azur, France
PC

Pascal Chanez

Professor
APHM
Marseille, Provence-Alpes-Cote d'Azur, France

Background: Endothelial injury and coagulation activation are prominent axis in coronavirus disease 19 (COVID-19) pathogenesis. However, only few studies have compared profiles of biomarkers of coagulopathy and endotheliopathy with regard to the initial severity of COVID-19 and the time course of the disease.

Aims: The main objective of our study is to point profiles of biomarkers of coagulopathy and endotheliopathy associated with initial severity of COVID-19 and the time course of the disease.

Methods: In a prospective longitudinal study, we explored coagulation and endothelial function biomarkers at admission, at day 3 and at day 7 in two cohorts of severe and moderate COVID-19 patients and according to outcome.

Results: We found that D-dimers, free tissue factor pathway inhibition (TFPI) and extracellular vesicles – tissue factor (EV-TF) at admission were associated with disease severity. Concerning outcome, TFPI, EV-TF and von Willebrand factor antigen (VWF)/ADAMTS13 ratio at admission, at day 3 and at day 7 were associated with not favorable outcome defined as the onset of death or need of invasive mechanical ventilation. TFPI with a cut-off value of 37.5 ng/mL had 87% sensitivity and 94% and specificity and EV-TF with a cut-off value of 13 fM had 87% sensitivity and 83% specificity. ROC curves analysis for severe outcome was significant with AUC = 0.90 for TFPI and AUC = 0.88 for EV-TF (p < 0.001 for both).

Conclusion(s): We found a specific profile of specialized biomarkers of coagulopathy and endotheliopathy associated with severe form of COVID-19 and not favorable outcome. We identified free TFPI and EV-TF of potential interest to stratify patient’s risk or to design specific treatment targeting coagulation pathways. Additional studies are warranted to confirm our results and study the interaction between these biomarkers’ values and anticoagulation treatment.