Inflammatory and Prothrombotic Biomarkers Associated With the Severity of COVID-19 Infection

Clin Appl Thromb Hemost. 2021 Jan-Dec:27:1076029621999099. doi: 10.1177/1076029621999099.

Abstract

Among COVID-19 hospitalized patients, high incidence of alterations in inflammatory and coagulation biomarkers correlates with a poor prognosis. Comorbidities such as chronic degenerative diseases are frequently associated with complications in COVID-19 patients. The aim of this study was to evaluate inflammatory and procoagulant biomarkers in COVID-19 patients from a public hospital in Mexico. Blood was sampled within the first 48 h after admission in 119 confirmed COVID-19 patients that were classified in 3 groups according to oxygen demand, evolution and the severity of the disease as follows: 1) Non severe: nasal cannula or oxygen mask; 2) Severe: high flow nasal cannula and 3) Death: mechanical ventilation eventually leading to fatal outcome. Blood samples from 20 healthy donors were included as a Control Group. Analysis of inflammatory and coagulation biomarkers including D-dimer, interleukin 6, interleukin 8, PAI-1, P-selectin and VWF was performed in plasma. Routine laboratory and clinical biomarkers were also included and compared among groups. Concentrations of D-dimer (14.5 ± 13.8 µg/ml) and PAI-1 (1223 ± 889.6 ng/ml) were significantly elevated in severe COVID-19 patients (P < 0.0001). A significant difference was found in interleukin-6, PAI-1 and P-selectin in non-severe and healthy donors when compared to Severe COVID-19 and deceased patients (P < 0.001). VWF levels were also significantly different between severe patients (153.5 ± 24.3 UI/dl) and non-severe ones (133.9 ± 20.2 UI/dl) (P < 0.0001). WBC and glucose levels were also significantly elevated in patients with Severe COVID-19. Plasma concentrations of all prothrombotic biomarkers were significantly higher in patients with a fatal outcome.

Keywords: COVID-19; D dimer; P-selectin; PAI-1; immunothrombosis; interleukin 6; interleukin 8; von Willebrand factor.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood*
  • COVID-19 / blood*
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • Case-Control Studies
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Hospitalization
  • Humans
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • P-Selectin / blood
  • Pandemics
  • Plasminogen Activator Inhibitor 1 / blood
  • Prognosis
  • SARS-CoV-2*
  • Severity of Illness Index
  • Thrombosis / blood
  • Thrombosis / etiology
  • von Willebrand Factor / metabolism

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin-6
  • P-Selectin
  • Plasminogen Activator Inhibitor 1
  • SELP protein, human
  • SERPINE1 protein, human
  • fibrin fragment D
  • von Willebrand Factor