AUTHOR=Ceballos Francisco C. , Ryan Pablo , Blancas Rafael , Martin-Vicente María , Vidal-Alcántara Erick Joan , Peréz-García Felipe , Bartolomé Sofía , Churruca-Sarasqueta Juan , Virseda-Berdices Ana , Martínez-González Oscar , Brochado-Kith Oscar , Rava Marta , Vilches-Medkouri Carolina , Blanca-López Natalia , Ramirez Martinez-Acitores Ignacio , Moreira-Escriche Patricia , De Juan Carmen , Resino Salvador , Fernández-Rodríguez Amanda , Jiménez-Sousa María Ángeles
TITLE=Are Reduced Levels of Coagulation Proteins Upon Admission Linked to COVID-19 Severity and Mortality?
JOURNAL=Frontiers in Medicine
VOLUME=8
YEAR=2021
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.718053
DOI=10.3389/fmed.2021.718053
ISSN=2296-858X
ABSTRACT=Background: The link between coagulation system disorders and COVID-19 has not yet been fully elucidated.
Aim: Evaluating the association of non-previously reported coagulation proteins with COVID-19 severity and mortality.
Design: Cross-sectional study of 134 COVID-19 patients recruited at admission and classified according to the highest COVID-19 severity reached (asymptomatic/mild, moderate, or severe) and 16 healthy control individuals.
Methods: Coagulation proteins levels (antithrombin, prothrombin, factor_XI, factor_XII, and factor_XIII) and CRP were measured in plasma by the ProcartaPlex Panel (Invitrogen) multiplex immunoassay upon diagnosis.
Results: We found higher levels of antithrombin, prothrombin, factor XI, factor XII, and factor XIII in asymptomatic/mild and moderate COVID-19 patients compared to healthy individuals. Interestingly, decreased levels of antithrombin and factors XI, XII, and XIII were observed in those patients who eventually developed severe illness. Additionally, survival models showed us that patients with lower levels of these coagulation proteins had an increased risk of death.
Conclusion: COVID-19 provokes early increments of some specific coagulation proteins in most patients. However, lower levels of these proteins at diagnosis might “paradoxically” imply a higher risk of progression to severe disease and COVID-19-related mortality.