Hypofibrinolytic state and high thrombin generation may play a major role in SARS‐COV2 associated thrombosis
| Autor: | Guillaume Marcotte, Remi Benoit, Marie Simon, Helene Desmurs-Clavel, Yesim Dargaud, Claude Negrier, Laurent Argaud, Christophe Nougier, Jean Stephane David, Aurelie Bonnet |
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| Přispěvatelé: | Institut de Combustion, Aérothermique, Réactivité et Environnement (ICARE), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS)-Institut des Sciences de l'Ingénierie et des Systèmes (INSIS), Laboratoire de Chimie Physique - Matière et Rayonnement (LCPMR), Institut de Chimie du CNRS (INC)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot, Service Anesthésie Réanimation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Instituto Superior de Agronomia, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment [SDV]Life Sciences [q-bio] 030204 cardiovascular system & hematology Fibrinogen Tissue plasminogen activator law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Intensive care Internal medicine Fibrinolysis Plasminogen Activator Inhibitor 1 medicine Coagulopathy Covid‐19 Tafi tissue plasminogen activator business.industry Brief Report Antithrombin Hematology medicine.disease Intensive care unit 3. Good health chemistry Plasminogen activator inhibitor-1 thrombin generation business Covid-19 medicine.drug |
| Zdroj: | Journal of Thrombosis and Haemostasis Journal of thrombosis and haemostasis : JTH Journal of thrombosis and haemostasis : JTH, 2020, ⟨10.1111/jth.15016⟩ |
| ISSN: | 1538-7836 1538-7933 |
| DOI: | 10.1111/jth.15016 |
| Popis: | Background Thirty percent of Covid-19 patients admitted to intensive care units present with thrombotic complications despite thromboprophylaxis. Bed rest, obesity, hypoxia, coagulopathy, and acute excessive inflammation are potential mechanisms reported by previous studies. Better understanding of the underlying mechanisms leading to thrombosis is crucial for developing more appropriate prophylaxis and treatment strategies. Objective We aimed to assess fibrinolytic activity and thrombin generation in 78 Covid-19 patients. Patients and methods Forty-eight patients admitted to the intensive care unit and 30 patients admitted to the internal medicine department were included in the study. All patients received thromboprophylaxis. We measured fibrinolytic parameters (tissue plasminogen activator, PAI-1, thrombin activatable fibrinolysis inhibitor, alpha2 anti-plasmin, and tissue plasminogen activator-modified ROTEM device), thrombin generation, and other coagulation tests (D-dimer, fibrinogen, factor VIII, antithrombin). Results and conclusions We observed two key findings: a high thrombin generation capacity that remained within normal values despite heparin therapy and a hypofibrinolysis mainly associated with increased PAI-1 levels. A modified ROTEM is able to detect both hypercoagulability and hypofibrinolysis simultaneously in Covid-19 patients with thrombosis. |
| Databáze: | OpenAIRE |
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