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Increased procoagulant platelet levels are predictive of death in COVID-19.
Khattab, Mohamad H; Prodan, Calin I; Vincent, Andrea S; Xu, Chao; Jones, Kellie R; Thind, Sharanjeet; Rabadi, Meheroz; Mithilesh, Shubhada; Mathews, Eleanor; Guthery, Leslie; Dale, George L; Kirkpatrick, Angelia C.
  • Khattab MH; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Prodan CI; Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
  • Vincent AS; Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
  • Xu C; Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Jones KR; Cognitive Science Research Center, University of Oklahoma, Norman, OK, USA.
  • Thind S; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Rabadi M; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Mithilesh S; Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
  • Mathews E; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
  • Guthery L; Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
  • Dale GL; Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
  • Kirkpatrick AC; Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Geroscience ; 43(4): 2055-2065, 2021 08.
Article in English | MEDLINE | ID: covidwho-1263172
ABSTRACT
Prior research has identified abnormal platelet procoagulant responses in COVID-19. Coated-platelets, a form of procoagulant platelets, support thrombin formation and are elevated in ischemic stroke patients with increased risk for recurrent infarction. Our goal was to examine changes in coated-platelet levels over the course of COVID-19 infection and determine their association with disease severity, thrombosis, and death. Coated-platelet levels were assayed after admission and repeated weekly in COVID-19 patients, and in COVID-19 negative controls. Receiver operator characteristic (ROC) analysis was used to calculate area under the curve (AUC) values for a model including baseline coated-platelets to predict death. Kaplan-Meier and Cox proportional hazards analysis was used to predict risk for death at 90 days. We enrolled 33 patients (22 with moderate and 11 with severe infection) and 20 controls. Baseline coated-platelet levels were lower among moderate (mean ± SD; 21.3 ± 9.8%) and severe COVID-19 patients (28.5 ± 11.9%) compared to controls (38.1 ± 10.4%, p < 0.0001). Coated-platelet levels increased during follow-up in COVID-19 patients by 7% (relative) per day from symptom onset (95% CI 2-12%, p = 0.007). A cut-off of 33.9% for coated-platelet levels yielded 80% sensitivity and 96% specificity for death at 90 days, with resulting AUC of 0.880 (95% CI 0.680-1.0, p = 0.0002). The adjusted hazard ratio for death in patients with coated-platelet levels > 33.9% was 40.99 when compared to those with levels ≤ 33.9% (p < 0.0001). Platelet procoagulant potential is transiently decreased in most patients during COVID-19; however, increased baseline platelet procoagulant levels predict death. Defining the mechanisms involved and potential links with aging may yield novel treatment targets.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Prognostic study Limits: Humans Language: English Journal: Geroscience Year: 2021 Document Type: Article Affiliation country: S11357-021-00385-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Prognostic study Limits: Humans Language: English Journal: Geroscience Year: 2021 Document Type: Article Affiliation country: S11357-021-00385-3