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Comparison of the coagulopathies associated with COVID-19 and sepsis

Robert A Campbell1,2, Yohei Hisada3,4, Frederik Denorme1

  • 1University of Utah Molecular Medicine Program Salt Lake City UT USA.

Research and Practice in Thrombosis and Haemostasis
|May 24, 2021
PubMed

Insights

Patients with COVID-19 and sepsis show elevated markers of coagulation. However, COVID-19 patients exhibit higher extracellular vesicle tissue factor (EVTF) activity and active plasminogen activator inhibitor 1 (PAI-1), potentially explaining lower d-dimer levels.

Area of Science:

  • Coagulation and Thrombosis Research
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) and sepsis are linked to coagulation activation and thrombosis.
  • Elevated plasma d-dimer levels in COVID-19 correlate with disease severity, thrombosis, and mortality.

Purpose of the Study:

  • To compare circulating extracellular vesicle tissue factor (EVTF) activity and active plasminogen activator inhibitor 1 (PAI-1) levels in patients with COVID-19 versus sepsis.

Main Methods:

  • Plasma samples were analyzed for d-dimer, EVTF activity, and active PAI-1.
  • Included patients with COVID-19 (ICU and non-ICU) and sepsis, compared to healthy controls.

Main Results:

  • COVID-19 patients showed higher d-dimer, EVTF activity, and active PAI-1 than controls.
  • Sepsis patients had higher d-dimer and EVTF activity than controls.
  • COVID-19 patients had lower d-dimer but higher EVTF activity (especially ICU) and active PAI-1 compared to sepsis patients.

Conclusions:

  • Elevated EVTF activity and active PAI-1 in COVID-19 may drive thrombosis via simultaneous coagulation activation and fibrinolysis inhibition.
  • High active PAI-1 in COVID-19 might reduce fibrin degradation, leading to lower d-dimer levels compared to sepsis.
Abstract

Keywords:
COVID‐19PAI‐1coagulationsepsistissue factor

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