PB0053 - NET formation in patients with COVID-19 and non-COVID-19 ARDS on venovenous ECMO

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

NB

Nina Buchtele

Resident
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria
MK

Marietta Kollars

Lab Technician
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria
HB

Heinz Burgmann

Professor for Infectious Diseases and Tropical Medicine
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria
PK

Paul A. Kyrle

Professor
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria
TS

Thomas Staudinger

Specialits in Intensive Care Medicine
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria

Presenting Author(s)

Sabine Eichinger, MD

Professor
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria

Co-Author(s)

Ludwig Traby, MD PhD

Consultant in Internal Medicine
Medical University of Vienna, Department of Medicine I
Vienna, Wien, Austria

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.