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dc.contributor.authorGoswami, Julie
dc.contributor.authorMacArthur, Taleen A.
dc.contributor.authorSridharan, Meera
dc.contributor.authorTange, Julie
dc.contributor.authorKirmse, Andrew J.
dc.contributor.authorLundell, Kaitlin A.
dc.contributor.authorChen, Dong
dc.contributor.authorAuton, Matthew T.
dc.contributor.authorChon, Tony Y.
dc.contributor.authorHurt, Ryan T.
dc.contributor.authorSalonen, Bradley R.
dc.contributor.authorGanesh, Ravindra
dc.contributor.authorErben, Young M.
dc.contributor.authorMarquez, Christopher P.
dc.contributor.authorDong, Jing Fei
dc.contributor.authorKozar, Rosemary A.
dc.contributor.authorHeller, Stephanie F.
dc.contributor.authorLoomis, Erica A.
dc.contributor.authorJohnstone, Andrea L.
dc.contributor.authorBailey, Kent R.
dc.contributor.authorSpears, Grant M.
dc.contributor.authorPark, Myung S.
dc.date.accessioned2022-03-18T12:41:43Z
dc.date.available2022-03-18T12:41:43Z
dc.date.issued2021-12-01
dc.identifier.urihttp://hdl.handle.net/10713/18288
dc.description.abstractBackground: COVID-19-associated coagulopathy is incompletely understood. Objectives: To characterize thrombin generation, Von Willebrand Factor (VWF), neutrophil extracellular traps (NETs), and their role in COVID-19 risk stratification in the emergency department (ED). Patients/methods: Plasma samples from 67 ED COVID-19 patients were compared to 38 healthy volunteers (HVs). Thrombin generation (calibrated automated thrombogram, CAT) was expressed as lag time (LT, min), peak height (PH, min), and time to peak (ttPeak, min). Citrullinated nucleosomes and histones were quantified with ELISA, VWF antigen and activity (IU/dL) through latex immunoassay, Factor VIII (IU/dL) through one-stage optical clot detection, and VWF multimers with Western blot densitometry. Wilcoxon testing and multivariable logistic regression were performed. Results presented as median [Q1, Q3]; p < 0.05 significant. Results: COVID-19 patients had longer LT (4.00 [3.26, 4.67]; 2.95 [2.67, 3.10], p < 0.001) and ttPeak (7.33 [6.33, 8.04]; 6.45 [6.00, 7.50], p = 0.004), greater VWF antigen (212 [158, 275]; 110 [91, 128], p < 0.001) and Factor VIII levels (148 [106, 190]; 106 [86, 129], p < 0.001), with decreased high molecular weight multimers (Normalized multimer ratio 0.807 [0.759, 0.869]; 0.891 [0.858, 0.966], p < 0.001), than HVs. COVID-19 patients requiring admission from the ED had longer LT and ttPeak with greater VWF antigen and Factor VIII levels than those not admitted. Two and three variable models of CAT parameters and VWF correlated with COVID-19 and admission status (C-statistics 0.677 to 0.922). Conclusions: Thrombin generation kinetics and VWF levels, independent of NETs, may have a role in predicting admission need for COVID-19 patients. © 2021 The Authorsen_US
dc.description.sponsorshipNational Institutes of Healthen_US
dc.description.urihttps://doi.org/10.1016/j.tru.2021.100090en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofThrombosis Updateen_US
dc.subjectCOVID-19en_US
dc.subjectExtracellular trapsen_US
dc.subjectThrombinen_US
dc.subjectVon Willebrand factoren_US
dc.titleBiomarkers of thromboinflammation correlate to COVID-19 infection and admission status in emergency department patientsen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.tru.2021.100090
dc.source.journaltitleThrombosis Update
dc.source.volume5


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