Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity.

التفاصيل البيبلوغرافية
العنوان:	Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity.
المؤلفون:	Okazaki E; University of Sao Paulo Medical School, Sao Paulo, Brazil.; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Barion BG; University of Sao Paulo Medical School, Sao Paulo, Brazil.; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., da Rocha TRF; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Di Giacomo G; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Ho YL; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Rothschild C; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Fatobene G; University of Sao Paulo Medical School, Sao Paulo, Brazil., de Carvalho Moraes BDG; University of Sao Paulo Medical School, Sao Paulo, Brazil., Stefanello B; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Villaça PR; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Rocha VG; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil., Orsi FA; Hospital das Clínicas da Faculdade de Medicina de Sao Paulo da USP, 255 - Cerqueira César, Sao Paulo, SP, 05403-000, Brazil. ferorsi@unicamp.br.; Department of Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil. ferorsi@unicamp.br.
المصدر:	Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2024 Apr; Vol. 57 (4), pp. 721-729. Date of Electronic Publication: 2024 Mar 25.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Kluwer Academic Publishers Country of Publication: Netherlands NLM ID: 9502018 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-742X (Electronic) Linking ISSN: 09295305 NLM ISO Abbreviation: J Thromb Thrombolysis Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: [Dordrecht ; Norwell, MA] : Kluwer Academic Publishers, c1994-
مواضيع طبية MeSH:	COVID-19* , Antifibrinolytic Agents* , Thrombophilia*, Humans ; Fibrinolysis ; Plasminogen Activator Inhibitor 1/pharmacology ; Post-Acute COVID-19 Syndrome
مستخلص:	Hypercoagulability and reduced fibrinolysis are well-established complications associated with COVID-19. However, the timelines for the onset and resolution of these complications remain unclear. The aim of this study was to evaluate, in a cohort of COVID-19 patients, changes in coagulation and fibrinolytic activity through ROTEM assay at different time points during the initial 30 days following the onset of symptoms in both mild and severe cases. Blood samples were collected at five intervals after symptoms onset: 6-10 days, 11-15 days, 16-20 days, 21-25 days, and 26-30 days. In addition, fibrinogen, plasminogen, PAI-1, and alpha 2-antiplasmin activities were determined. Out of 85 participants, 71% had mild COVID-19. Twenty uninfected individuals were evaluated as controls. ROTEM parameters showed a hypercoagulable state among mild COVID-19 patients beginning in the second week of symptoms onset, with a trend towards reversal after the third week of symptoms. In severe COVID-19 cases, hypercoagulability was observed since the first few days of symptoms, with a tendency towards reversal after the fourth week of symptoms onset. A hypofibrinolytic state was identified in severe COVID-19 patients from early stages and persisted even after 30 days of symptoms. Elevated activity of PAI-1 and alpha 2-antiplasmin was also detected in severe COVID-19 patients. In conclusion, both mild and severe cases of COVID-19 exhibited transient hypercoagulability, reverted by the end of the first month. However, severe COVID-19 cases sustain hypofibrinolysis throughout the course of the disease, which is associated with elevated activity of fibrinolysis inhibitors. Persistent hypofibrinolysis could contribute to long COVID-19 manifestations. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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معلومات مُعتمدة:	88887.679326/2023-00 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; 038018/2021 Ministério da Saúde
فهرسة مساهمة:	Keywords: COVID-19; Hypercoagulability; Hypofibrinolysis; Rotational thromboelastometry; SARS-CoV-2
المشرفين على المادة:	0 (Plasminogen Activator Inhibitor 1) 0 (Antifibrinolytic Agents)
تواريخ الأحداث:	Date Created: 20240325 Date Completed: 20240419 Latest Revision: 20240419
رمز التحديث:	20240419
DOI:	10.1007/s11239-024-02961-8
PMID:	38523179
قاعدة البيانات:	MEDLINE

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تدمد:	1573-742X
DOI:	10.1007/s11239-024-02961-8