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Platelet Reactivity and Coagulation Markers in Patients with COVID-19.
Bertolin, Adriadne J; Dalçóquio, Talia F; Salsoso, Rocío; de M Furtado, Remo H; Kalil-Filho, Roberto; Hajjar, Ludhmila A; Siciliano, Rinaldo F; Kallás, Esper G; Baracioli, Luciano M; Lima, Felipe G; Giraldez, Roberto R; Cavalheiro-Filho, Cyrillo; Vieira, Alexandra; Strunz, Célia M C; Giugliano, Robert P; Tantry, Udaya S; Gurbel, Paul A; Nicolau, José C.
  • Bertolin AJ; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Dalçóquio TF; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Salsoso R; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • de M Furtado RH; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Kalil-Filho R; Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil.
  • Hajjar LA; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Siciliano RF; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Kallás EG; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Baracioli LM; Department of Infectious and Parasitic Diseases, University of São Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Lima FG; Department of Infectious and Parasitic Diseases, University of São Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Giraldez RR; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Cavalheiro-Filho C; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Vieira A; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Strunz CMC; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Giugliano RP; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Tantry US; Faculdade de Medicina, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
  • Gurbel PA; TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
  • Nicolau JC; TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Adv Ther ; 38(7): 3911-3923, 2021 07.
Article in English | MEDLINE | ID: covidwho-1258274
ABSTRACT
INTRODUTION COVID-19 is associated with an increased risk of thrombotic events. However, the contribution of platelet reactivity (PR) to the aetiology of the increased thrombotic risk associated with COVID-19 remains unclear. Our aim was to evaluate PR in stable patients diagnosed with COVID-19 and hospitalized with respiratory symptoms (mainly dyspnoea and dry cough), in comparison with a control group comprised of non-hospitalized healthy controls.

METHODS:

Observational, case control study that included patients with confirmed COVID-19 (COVID-19 group, n = 60) and healthy individuals matched by age and sex (control group, n = 60). Multiplate electrode aggregometry (MEA) tests were used to assess PR with adenosine diphosphate (MEA-ADP, low PR defined as < 53 AUC), arachidonic acid (MEA-ASPI, low PR < 86 AUC) and thrombin receptor-activating peptide 6 (MEA-TRAP, low PR < 97 AUC) in both groups.

RESULTS:

The rates of low PR with MEA-ADP were 27.5% in the COVID-19 group and 21.7% in the control group (OR = 1.60, p = 0.20); with MEA-ASPI, the rates were, respectively, 37.5% and 22.5% (OR = 3.67, p < 0.001); and with MEA-TRAP, the incidences were 48.5% and 18.8%, respectively (OR = 9.58, p < 0.001). Levels of D-dimer, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) were higher in the COVID-19 group in comparison with the control group (all p < 0.05). Thromboelastometry was utilized in a subgroup of patients and showed a hypercoagulable state in the COVID-19 group.

CONCLUSION:

Patients hospitalized with non-severe COVID-19 had lower PR compared to healthy controls, despite having higher levels of D-dimer, fibrinogen, and PAI-1, and hypercoagulability by thromboelastometry. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT04447131.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Adv Ther Journal subject: Therapeutics Year: 2021 Document Type: Article Affiliation country: S12325-021-01803-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Adv Ther Journal subject: Therapeutics Year: 2021 Document Type: Article Affiliation country: S12325-021-01803-w