Abstract

Background

Coronavirus disease 2019 (COVID‐19) is associated with activation of coagulation that mainly presents as thrombosis. Sepsis is also associated with activation of coagulation that mainly presents as disseminated intravascular coagulation. Many studies have reported increased levels of plasma D‐dimer in patients with COVID‐19 that is associated with severity, thrombosis, and mortality.

Objectives

The aim of this study was to compare levels of circulating extracellular vesicle tissue factor (EVTF) activity and active plasminogen activator inhibitor 1 (PAI‐1) in plasma from patients with COVID‐19 or sepsis.

Methods

We measured levels of D‐dimer, EVTF activity, and active PAI‐1 in plasma samples from patients with COVID‐19 (intensive care unit [ICU], N = 15; and non‐ICU, N = 20) and patients with sepsis (N = 35).

Results

Patients with COVID‐19 had significantly higher levels of D‐dimer, EVTF activity, and active PAI‐1 compared with healthy controls. Patients with sepsis had significantly higher levels of D‐dimer and EVTF activity compared with healthy controls. Levels of D‐dimer were significantly lower in patients with COVID‐19 compared with patients with sepsis. Levels of EVTF activity were significantly higher in ICU patients with COVID‐19 compared with patients with sepsis. Levels of active PAI‐1 were significantly higher in patients with COVID‐19 compared with patients with sepsis.

Conclusions

High levels of both EVTF activity and active PAI‐1 may promote thrombosis in patients with COVID‐19 due to simultaneous activation of coagulation and inhibition of fibrinolysis. The high levels of active PAI‐1 in patients with COVID‐19 may limit plasmin degradation of crosslinked fibrin and the release of D‐dimer. This may explain the lower levels of D‐dimer in patients with COVID‐19 compared with patients with sepsis.

Details

Title
Comparison of the coagulopathies associated with COVID‐19 and sepsis
Author
Campbell, Robert A 1 ; Hisada, Yohei 2   VIAFID ORCID Logo  ; Denorme, Frederik 3 ; Grover, Steven P 2   VIAFID ORCID Logo  ; Bouck, Emma G 4 ; Middleton, Elizabeth A 5 ; Wolberg, Alisa S 4   VIAFID ORCID Logo  ; Rondina, Matthew T 6 ; Mackman, Nigel 2   VIAFID ORCID Logo 

1  University of Utah Molecular Medicine Program, Salt Lake City, UT, USA; Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA 
2  UNC Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 
3  University of Utah Molecular Medicine Program, Salt Lake City, UT, USA 
4  UNC Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 
5  Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA 
6  University of Utah Molecular Medicine Program, Salt Lake City, UT, USA; George E. Wahlen VAMC Department of Internal Medicine and GRECC, Salt Lake City, UT, USA; Department of Pathology, University of Utah, Salt Lake City, UT, USA 
Section
BRIEF REPORTS
Publication year
2021
Publication date
May 2021
Publisher
Elsevier Limited
e-ISSN
24750379
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/rth2.12525
ProQuest document ID
2534508078
Copyright
© 2021. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.