1
|
Smadja DM, Gendron N, Philippe A, Diehl JL, Ochat N, Bory O, Beauvais A, Mareau A, Jannot AS, Chocron R. Fibrin monomers evaluation during hospitalization for COVID-19 is a predictive marker of in-hospital mortality. Front Cardiovasc Med 2023; 10:1001530. [PMID: 37063947 PMCID: PMC10098364 DOI: 10.3389/fcvm.2023.1001530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 02/28/2023] [Indexed: 04/01/2023] Open
Abstract
BackgroundCoagulopathy is one of the main triggers of severity and worsening of Coronavirus disease 2019 (COVID-19) particularly in critically ill patients. D-dimer has been widely used to detect COVID-19 coagulation disorders and has been correlated with outcomes such as disease severity and in-hospital mortality. Involvement of other fibrin degradation products, particularly fibrin monomers (FM), remains an ongoing question.MethodsWe performed a monocentric study of adult patients with COVID-19, who were admitted either in the medical ward (MW) or in the intensive care unit (ICU) and who had FM measurements performed on them during the first wave of COVID-19 outbreak. We analyzed the positivity of FM levels (FM > 7 µg/mL) to assess the ability of FM monitoring during the first days of hospitalization to predict COVID-19 outcomes.ResultsIn our cohort, 935 FM measurements were performed in 246 patients during their first 9 days of hospitalization. During patient follow-up, the FM levels were higher in patients admitted directly to the ICU than in those admitted to the MW. Moreover, we observed significantly increased levels of FM in patients when the data were stratified for in-hospital mortality. At hospital admission, only 27 (11%) patients displayed a positive value for FM; this subgroup did not differ from other patients in terms of severity (indicated by ICU referral at admission) or in-hospital mortality. When analyzing FM positivity in the first 9 days of hospitalization, we found that 37% of patients had positive FM at least once during hospitalization and these patients had increased in-hospital mortality (p = 0.001). Thus, we used non-adjusted Kaplan–Meier curves for in-hospital mortality according to FM positivity during hospitalization and we observed a statistically significant difference for in-hospital mortality (hazard ratio = 1.48, 95% CI: 1.25–1.76, p < 0.001). However, we compared the AUC of FM positivity associated with a ratio of D-dimer >70% and found that this combined receiver operating characteristic (ROC) curve was superior to the FM positivity ROC curve alone.ConclusionMonitoring of FM positivity in hospitalized patients with COVID-19 could be a reliable and helpful tool to predict the worsening condition and mortality of COVID-19.
Collapse
Affiliation(s)
- David M. Smadja
- Innovative Therapies in Hemostasis, INSERM, University Paris Cité, Paris, France
- Hematology Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
- Correspondence: David M. Smadja
| | - Nicolas Gendron
- Innovative Therapies in Hemostasis, INSERM, University Paris Cité, Paris, France
- Hematology Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Aurélien Philippe
- Innovative Therapies in Hemostasis, INSERM, University Paris Cité, Paris, France
- Hematology Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Jean-Luc Diehl
- Innovative Therapies in Hemostasis, INSERM, University Paris Cité, Paris, France
- Intensive Care Unit, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Nadège Ochat
- Hematology Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Olivier Bory
- Emergency Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Agathe Beauvais
- Emergency Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
| | - Alexis Mareau
- Centre de Recherche des Cordeliers, AP-HP.CUP, Georges Pompidou European Hospital, Medical Informatics, Biostatistics and Public Health Department, European Georges Pompidou Hospital, AP-HP.CUP, University Paris Cité, Paris, France
| | - Anne-Sophie Jannot
- Centre de Recherche des Cordeliers, AP-HP.CUP, Georges Pompidou European Hospital, Medical Informatics, Biostatistics and Public Health Department, European Georges Pompidou Hospital, AP-HP.CUP, University Paris Cité, Paris, France
| | - Richard Chocron
- Emergency Department, AP-HP.CUP, Georges Pompidou European Hospital, Paris, France
- PARCC, INSERM, University Paris Cité, Paris, France
| |
Collapse
|
2
|
Wauthier L, Favresse J, Hardy M, Douxfils J, Le Gal G, Roy P, van Es N, Ay C, ten Cate H, Lecompte T, Lippi G, Mullier F. D-dimer testing: A narrative review. Adv Clin Chem 2023. [DOI: 10.1016/bs.acc.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
|
3
|
Hardy M, Michaux I, Bulpa P, Schonau B, Nicolay B, de Maistre E, Godon A, Lecompte T, Mullier F. Serial fibrin monomer and D-dimer plasma levels measurements can capture thrombotic complications in critically ill COVID-19 patients: A prospective observational study. Thromb Res 2023; 221:69-72. [PMID: 36476478 PMCID: PMC9712142 DOI: 10.1016/j.thromres.2022.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Affiliation(s)
- M. Hardy
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Science (NARILIS), Hematology Laboratory, Namur, Belgium,CHU UCL Namur, Anesthesiology Department, Namur, Belgium,Corresponding author at: Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Science (NARILIS), Hematology Laboratory, Namur, Belgium
| | - I. Michaux
- Université catholique de Louvain, CHU UCL Namur, Intensive Care Medicine Department, Namur, Belgium
| | - P. Bulpa
- Université catholique de Louvain, CHU UCL Namur, Intensive Care Medicine Department, Namur, Belgium
| | - B. Schonau
- CHU UCL Namur, Vascular Medicine Department, Namur, Belgium
| | - B. Nicolay
- CHU UCL Namur, Anesthesiology Department, Namur, Belgium
| | - E. de Maistre
- Service d'Hématologie Biologique, Unité d'hémostase, CHU Dijon, Dijon, France
| | - A. Godon
- Department of Anesthesiology and Critical Care, Grenoble Alpes University Hospital, Grenoble, France
| | - T. Lecompte
- University of Namur, Pharmacy Department, Namur, Belgium,Université de Lorraine, Nancy, France
| | - F. Mullier
- Université catholique de Louvain, CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Science (NARILIS), Hematology Laboratory, Namur, Belgium
| |
Collapse
|
4
|
Weber C, Rigby A, Lip GYH. Thrombosis and Haemostasis 2021 Editors' Choice Papers. Thromb Haemost 2022; 122:163-170. [PMID: 35038760 DOI: 10.1055/s-0041-1741072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Christian Weber
- Institute for Cardiovascular Prevention (IPEK), LMU Munich, Munich, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.,Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne Rigby
- Institute for Cardiovascular Prevention (IPEK), LMU Munich, Munich, Germany
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|