Dissemination of extreme levels of extracellular vesicles: tissue factor activity in patients with severe COVID-19

Autor: Françoise Dignat-George, Evelyne Abdili, Raphael Cauchois, Gilles Kaplanski, Christophe Guervilly, Léa Pietri, Laurent Papazian, Romaric Lacroix, Laurent Arnaud, Florence Sabatier, Jacques Albanèse, Thomas Robert, Amandine Bonifay, Mélanie Velier, Guillaume Lano, Stéphane Burtey
Přispěvatelé: Hôpital Nord [CHU - APHM], Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Lucas, Nelly
Rok vydání: 2020
Předmět:
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology
0301 basic medicine
Male
Pilot Projects
Disease
030204 cardiovascular system & hematology
Gastroenterology
Severity of Illness Index
chemistry.chemical_compound
0302 clinical medicine
Aged
80 and over
[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Hematology
Middle Aged
Thrombosis
3. Good health
Plasminogen activator inhibitor-1
Area Under Curve
Cohort
Female
medicine.symptom
Risk
medicine.medical_specialty
Inflammation
macromolecular substances
Thromboplastin
Fibrin Fibrinogen Degradation Products
03 medical and health sciences
Extracellular Vesicles
Internal medicine
Severity of illness
Plasminogen Activator Inhibitor 1
medicine
Coagulopathy
Humans
Aged
Proportional Hazards Models
Septic shock
business.industry
SARS-CoV-2
COVID-19
medicine.disease
Stimulus Report
030104 developmental biology
Logistic Models
chemistry
ROC Curve
business
Zdroj: Blood Advances
Blood Advances, 2021, 5 (3), pp.628-634. ⟨10.1182/bloodadvances.2020003308⟩
Blood Advances, The American Society of Hematology, 2021, 5 (3), pp.628-634. ⟨10.1182/bloodadvances.2020003308⟩
ISSN: 2473-9537
2473-9529
DOI: 10.1182/bloodadvances.2020003308⟩
Popis: Key Points EV-TF activity is dramatically increased in patients with severe COVID-19 and is associated with an increased thrombotic risk. Compared with patients with septic shock, those with severe COVID-19 display a distinct EV profile with higher procoagulant activity.
Coronavirus disease 2019 (COVID-19) has become one of the biggest public health challenges of this century. Severe forms of the disease are associated with a thrombo-inflammatory state that can turn into thrombosis. Because tissue factor (TF) conveyed by extracellular vesicles (EVs) has been implicated in thrombosis, we quantified the EV-TF activity in a cohort of hospitalized patients with COVID-19 (n = 111) and evaluated its link with inflammation, disease severity, and thrombotic events. Patients with severe disease were compared with those who had moderate disease and with patients who had septic shock not related to COVID-19 (n = 218). The EV-TF activity was notably increased in patients with severe COVID-19 compared with that observed in patients with moderate COVID-19 (median, 231 [25th to 75th percentile, 39-761] vs median, 25 [25th to 75th percentile, 12-59] fM; P < .0001); EV-TF was correlated with leukocytes, D-dimer, and inflammation parameters. High EV-TF values were associated with an increased thrombotic risk in multivariable models. Compared with patients who had septic shock, those with COVID-19 were characterized by a distinct coagulopathy profile with significantly higher EV-TF and EV-fibrinolytic activities that were not counterbalanced by an increase in plasminogen activator inhibitor-1 (PAI-1). Thus, this article is the first to describe the dissemination of extreme levels of EV-TF in patients with severe COVID-19, which supports the international recommendations of systematic preventive anticoagulation in hospitalized patients and potential intensification of anticoagulation in patients with severe disease.
Databáze: OpenAIRE
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