Evidence for secondary thrombotic microangiopathy in COVID-19
The causes of coagulopathy associated with COVID-19 disease are poorly understood. We aimed to investigate the relationship between markers of endothelial activation, intravascular hemolysis, coagulation, and organ damage in COVID-19 patients and study their association with disease severity and mortality. We conducted a retrospective study of 181 hospitalized COVID-19 patients randomly selected with equal distribution of survivors and non-survivors. Patients who died had significantly lower ADAMTS13 activity, significantly higher LDH, schistocytes and von Willebrand Factor levels compared to patients discharged alive. Only 30% of patients with an initial ADAMTS13 activity <43% survived vs. 60% with ADAMTS13 ≥43% who survived. In conclusion, COVID-19 may manifest as a TMA-like illness in a subset of hospitalized patients. Presence of schistocytes on admission may warrant a work-up for TMA. These findings indicate the need for future investigation to study the relationship between endothelial and coagulation activation and the efficacy of TMA treatments in COVID-19.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2020 |
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| Enthalten in: |
medRxiv : the preprint server for health sciences - (2020) vom: 23. Okt. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sweeney, Joseph M [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Revised 19.10.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1101/2020.10.20.20215608 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316755478 |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a The causes of coagulopathy associated with COVID-19 disease are poorly understood. We aimed to investigate the relationship between markers of endothelial activation, intravascular hemolysis, coagulation, and organ damage in COVID-19 patients and study their association with disease severity and mortality. We conducted a retrospective study of 181 hospitalized COVID-19 patients randomly selected with equal distribution of survivors and non-survivors. Patients who died had significantly lower ADAMTS13 activity, significantly higher LDH, schistocytes and von Willebrand Factor levels compared to patients discharged alive. Only 30% of patients with an initial ADAMTS13 activity <43% survived vs. 60% with ADAMTS13 ≥43% who survived. In conclusion, COVID-19 may manifest as a TMA-like illness in a subset of hospitalized patients. Presence of schistocytes on admission may warrant a work-up for TMA. These findings indicate the need for future investigation to study the relationship between endothelial and coagulation activation and the efficacy of TMA treatments in COVID-19 | ||
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| 700 | 1 | |a Barouqa, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Krause, Gregory J |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Lugo, Jesus D |e verfasserin |4 aut | |
| 700 | 1 | |a Rahman, Shafia |e verfasserin |4 aut | |
| 700 | 1 | |a Gil, Morayma Reyes |e verfasserin |4 aut | |
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