Inflammation-Induced Coagulopathy Substantially Differs Between COVID-19 and Septic Shock: A Prospective Observational Study

Frontiers in Medicine

Marc Derive¹  Lucie Jolly¹  Laure Dumoutier²  Christophe Beauloye³  Laurent Gatto⁴  Manon Martin⁴  Mélanie Dechamps⁵  Marie-Astrid Van Dievoet⁶  Damien Gruson⁶  Virginie Montiel⁷  Diego Castanares-Zapatero⁷  Pierre-François Laterre⁷  Caroline Bouzin⁹  Aurélie Daumerie⁹  Ludovic Gerard^1,10  Alessandro Campion^1,11  Marie Octave^1,11  Valentine Robaux^1,11  Luc Bertrand^1,11  Audrey Ginion^1,11  Julien De Poortere^1,11  Laurence Pirotton^1,11  Sandrine Horman^1,11  Julie Bodart^1,11  Laure Morimont^1,12  Hélène Haguet^1,12  Jonathan Douxfils^1,12 

[1] 0Inotrem s.a., Vandoeuvre-les-Nancy, France;1Experimental Medicine Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium;2Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Computational Biology and Bioinformatics Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium;Department of Cardiovascular Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Department of Clinical Biology, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Department of Pharmacy, Namur Research Institute for Life Sciences, Namur, Belgium;IREC Imaging Platform, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Pôle de Pneumologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Qualiblood, s.a., Namur, Belgium;

关键词: COVID-19;    septic shock;    inflammation;    coagulopathy;    platelet;    NETosis;   

DOI  :  10.3389/fmed.2021.780750

来源: DOAJ

【 摘 要 】

Critical COVID-19, like septic shock, is related to a dysregulated systemic inflammatory reaction and is associated with a high incidence of thrombosis and microthrombosis. Improving the understanding of the underlying pathophysiology of critical COVID-19 could help in finding new therapeutic targets already explored in the treatment of septic shock. The current study prospectively compared 48 patients with septic shock and 22 patients with critical COVID-19 regarding their clinical characteristics and outcomes, as well as key plasmatic soluble biomarkers of inflammation, coagulation, endothelial activation, platelet activation, and NETosis. Forty-eight patients with matched age, gender, and co-morbidities were used as controls. Critical COVID-19 patients exhibited less organ failure but a prolonged ICU length-of-stay due to a prolonged respiratory failure. Inflammatory reaction of critical COVID-19 was distinguished by very high levels of interleukin (IL)-1β and T lymphocyte activation (including IL-7 and CD40L), whereas septic shock displays higher levels of IL-6, IL-8, and a more significant elevation of myeloid response biomarkers, including Triggering Receptor Expressed on Myeloid cells-1 (TREM-1) and IL-1ra. Subsequent inflammation-induced coagulopathy of COVID-19 also differed from sepsis-induced coagulopathy (SIC) and was characterized by a marked increase in soluble tissue factor (TF) but less platelets, antithrombin, and fibrinogen consumption, and less fibrinolysis alteration. In conclusion, COVID-19 inflammation-induced coagulopathy substantially differs from SIC. Modulating TF release and activity should be evaluated in critical COVID-19 patients.

【 授权许可】

Unknown