Curative anticoagulation prevents endothelial lesion in COVID-19 patients

Lina Khider, Nicolas Gendron, Guillaume Goudot, Richard Chocron, Caroline Hauw-Berlemont, Charles Cheng, Nadia Rivet, Helene Pere, Ariel Roffe, Sébastien Clerc, David Lebeaux, Benjamin Debuc, David Veyer, Bastien Rance, Pascale Gaussem, Sébastien Bertil, Cécile Badoual, Philippe Juvin, Benjamin Planquette, Emmanuel MessasOlivier Sanchez, Jean Sébastien Hulot, Jean Luc Diehl, Tristan Mirault, David M. Smadja

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: Coronavirus disease-2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. Objectives: To explore the coagulopathy and endothelial dysfunction in COVID-19 patients. Methods: The study analyzed clinical and biological profiles of patients with suspected COVID-19 infection at admission, including hemostasis tests and quantification of circulating endothelial cells (CECs). Results: Among 96 consecutive COVID-19-suspected patients fulfilling criteria for hospitalization, 66 were tested positive for SARS-CoV-2. COVID-19-positive patients were more likely to present with fever (P =.02), cough (P =.03), and pneumonia at computed tomography (CT) scan (P =.002) at admission. Prevalence of D-dimer >500 ng/mL was higher in COVID-19-positive patients (74.2% versus 43.3%; P =.007). No sign of disseminated intravascular coagulation were identified. Adding D-dimers >500 ng/mL to gender and pneumonia at CT scan in receiver operating characteristic curve analysis significantly increased area under the curve for COVID-19 diagnosis. COVID-19-positive patients had significantly more CECs at admission (P =.008) than COVID-19-negative ones. COVID-19-positive patients treated with curative anticoagulant prior to admission had fewer CECs (P =.02) than those without. Interestingly, patients treated with curative anticoagulation and angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers had even fewer CECs (P =.007). Conclusion: Curative anticoagulation could prevent COVID-19-associated coagulopathy and endothelial lesion.
Original languageEnglish
JournalJournal of Thrombosis and Haemostasis
Volume18
Issue number9
DOIs
StatePublished - 1 Sep 2020

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