Related Experiment Video
Updated: Jun 7, 2025
Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States
Published on: April 1, 2015
Association Between Coagulation Fibrinolysis Markers and Severity in Patients with COVID-19
Takuya Iwamoto1, Yuki Hatayama1,2, Noriko Yamashita1
1Division of Clinical Laboratory Medicine, Tottori University Hospital, Yonago, Tottori, Japan.
Insights
Plasmin-plasmin inhibitor complex (PIC) and D-dimer (DD) indicate COVID-19 severity, unlike fibrin monomer complex (FMC). PIC showed the most significant difference between mild and moderate COVID-19 cases, suggesting its role in coagulation imbalance.
Area of Science:
- Biochemistry
- Hematology
- Infectious Diseases
Background:
- Thrombosis is a significant COVID-19 complication.
- D-dimer (DD) is a known marker, but other fibrinolysis markers like plasmin-plasmin inhibitor complex (PIC) and fibrin monomer complex (FMC) roles are less understood.
- Investigating these markers can offer insights into COVID-19 pathophysiology.
Purpose of the Study:
- To compare the associations of DD, PIC, and FMC with COVID-19 severity.
- To evaluate the correlation of these markers with established COVID-19 severity indicators.
- To identify potential biomarkers for assessing coagulation and fibrinolysis imbalance in COVID-19 patients.
Main Methods:
- Plasma samples from 50 COVID-19 patients (36 mild, 14 moderate) were analyzed for DD, FMC, and PIC levels.
- Levels were compared between mild and moderate disease groups.
- Correlations with lactate dehydrogenase (LD), serum albumin (Alb), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR) were assessed.
Main Results:
- Moderate COVID-19 patients exhibited significantly higher DD and PIC levels compared to mild cases; FMC levels were similar.
- DD and PIC levels correlated significantly with LD, Alb, and NLR.
- PIC also correlated significantly with CRP, while FMC only correlated with Alb.
Conclusions:
- COVID-19 severity is associated with PIC and DD levels, but not FMC.
- PIC demonstrated the clearest distinction between moderate and mild COVID-19, indicating its potential as a marker for coagulation and fibrinolysis imbalance.
- Further research with larger cohorts is needed to validate these findings.
Introduction:
Thrombosis is a major complication of COVID-19. D-dimer (DD) is an important coagulation fibrinolysis marker in COVID-19 and has been extensively studied. However, very little is known about the role of other fibrinolysis markers, plasmin-plasmin inhibitor complex (PIC), and fibrin monomer complex (FMC) in COVID-19. This study investigated and compared the associations of DD, PIC, and FMC with COVID-19 severity.
Methods:
Archived plasma samples from patients with COVID-19 (n = 50) were assessed for DD, FMC, and PIC levels. We compared the levels between patients with mild (n = 36) and moderate (n = 14) COVID-19 and evaluated their correlation with other COVID-19 severity markers, including lactate dehydrogenase (LD), serum albumin (Alb), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR).
Results:
Patients with moderate COVID-19 had significantly higher DD and PIC levels than those with mild disease, while FMC levels were comparable. DD and PIC levels significantly correlated with LD, Alb, and NLR. Additionally, PIC levels significantly correlated with CRP levels. However, FMC levels correlated only with Alb but not with LD, NLR, or CRP.
Conclusions:
COVID-19 severity was significantly associated with PIC and DD levels but not with FMC levels. PIC was the variable with the most clearly significant difference between patients with moderate disease and those with mild disease, highlighting its potential as an indicator of coagulation and fibrinolysis imbalance in patients with COVID-19. Further studies with larger sample sizes and more diverse severity groups are required to confirm these findings.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:16Clot Retraction and Fibrinolysis
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:09Coagulation
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:20Extrinsic and Intrinsic Pathways of Hemostasis
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...