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Inflammatory and Hypercoagulable Biomarkers and Clinical Outcomes in COVID-19 Patients.
Kitakata, Hiroki; Kohsaka, Shun; Kuroda, Shunsuke; Nomura, Akihiro; Kitai, Takeshi; Yonetsu, Taishi; Torii, Sho; Matsue, Yuya; Matsumoto, Shingo.
  • Kitakata H; Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan.
  • Kohsaka S; Department of Cardiology, Keio University School of Medicine, Tokyo 160-8582, Japan.
  • Kuroda S; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
  • Nomura A; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa 920-8641, Japan.
  • Kitai T; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe 650-0047, Japan.
  • Yonetsu T; Department of Interventional Cardiology, Tokyo Medical and Dental University, Tokyo 113-8513, Japan.
  • Torii S; Department of Cardiology, Tokai University School of Medicine, Isehara 259-1193, Japan.
  • Matsue Y; Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.
  • Matsumoto S; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan.
J Clin Med ; 10(14)2021 Jul 13.
Article in English | MEDLINE | ID: covidwho-1314671
ABSTRACT
Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes remains unknown. The CLAVIS-COVID registry was a Japanese nationwide retrospective multicenter observational study, supported by the Japanese Circulation Society. Consecutive hospitalized patients with pre-existing CVD and COVID-19 were enrolled. Patients were stratified by the tertiles of CRP and D-dimer values at the time of admission. Multivariable Cox proportional hazard models were constructed. In 461 patients (65.5% male; median age, 70.0), the median baseline CRP and D-dimer was 58.3 (interquartile range, 18.2-116.0) mg/L and 1.5 (interquartile range, 0.8-3.0) mg/L, respectively. Overall, the in-hospital mortality rate was 16.5%, and the rates steadily increased in concordance with both CRP (5.0%, 15.0%, and 28.2%, respectively p < 0.001) and D-dimer values (6.8%, 19.6%, and 22.5%, respectively p = 0.001). Patients with the lowest tertiles of both biomarkers (CRP, 29.0 mg/L; D-dimer, 1.00 mg/L) were at extremely low risk of in-hospital mortality (0% until day 50, and 1.4% overall). Conversely, the elevation of both CRP and D-dimer levels was a significant predictor of in-hospital mortality (Hazard ratio, 2.97; 95% confidence interval, 1.57-5.60). A similar trend was observed when the biomarker threshold was set at a clinically relevant threshold. In conclusion, the combination of these abnormalities may provide a framework for rapid risk estimation for in-hospital COVID-19 patients with CVD.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10143086

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10143086