Frontiers in Medicine | |
Inflammation-Induced Coagulopathy Substantially Differs Between COVID-19 and Septic Shock: A Prospective Observational Study | |
Medicine | |
Manon Martin1  Laurent Gatto1  Damien Gruson2  Marie-Astrid Van Dievoet2  Pierre-François Laterre3  Virginie Montiel3  Ludovic Gerard4  Laure Morimont5  Jonathan Douxfils5  Hélène Haguet5  Laure Dumoutier6  Caroline Bouzin7  Aurélie Daumerie7  Lucie Jolly8  Marc Derive8  Laurence Pirotton9  Julie Bodart9  Sandrine Horman9  Marie Octave9  Valentine Robaux9  Luc Bertrand9  Julien De Poortere9  Alessandro Campion9  Audrey Ginion9  Mélanie Dechamps1,10  Diego Castanares-Zapatero1,11  Christophe Beauloye1,12  | |
[1] Computational Biology and Bioinformatics Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium;Department of Clinical Biology, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Pôle de Pneumologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Department of Pharmacy, Namur Research Institute for Life Sciences, Namur, Belgium;Qualiblood, s.a., Namur, Belgium;Experimental Medicine Unit, de Duve Institute, Université Catholique de Louvain, Brussels, Belgium;IREC Imaging Platform, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Inotrem s.a., Vandoeuvre-les-Nancy, France;Pôle de Recherche Cardiovasculaire, 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;Department of Cardiovascular Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Department of Intensive Care, Cliniques Universitaires Saint-Luc, Brussels, Belgium;Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium;Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; | |
关键词: COVID-19; septic shock; inflammation; coagulopathy; platelet; NETosis; endothelium; | |
DOI : 10.3389/fmed.2021.780750 | |
received in 2021-09-21, accepted in 2021-12-24, 发布年份 2022 | |
来源: Frontiers | |
【 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
Copyright © 2022 Dechamps, De Poortere, Martin, Gatto, Daumerie, Bouzin, Octave, Ginion, Robaux, Pirotton, Bodart, Gerard, Montiel, Campion, Gruson, Van Dievoet, Douxfils, Haguet, Morimont, Derive, Jolly, Bertrand, Dumoutier, Castanares-Zapatero, Laterre, Horman and Beauloye.
【 预 览 】
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RO202310107458301ZK.pdf | 4056KB | download |