The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19
In some patients, SARS-CoV-2 infection induces cytokine storm, hypercoagulability and endothelial cell activation leading to worsening of COVID-19, intubation and death. Prompt identification of patients at risk of intubation is an urgent need. Objectives. To derive a prognostic score for the risk o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Hemato |
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| Online Access: | https://www.mdpi.com/2673-6357/3/1/17 |
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| author | Grigoris T. Gerotziafas Patrick Van Dreden Douglas D. Fraser Guillaume Voiriot Maitray A. Patel Mark Daley Alexandre Elabbadi Aurélie Rousseau Yannis Prassas Matthieu Turpin Marina Marchetti Loula Papageorgiou Evangelos Terpos Meletios A. Dimopoulos Anna Falanga Jawed Fareed Muriel Fartoukh Ismail Elalamy |
| author_facet | Grigoris T. Gerotziafas Patrick Van Dreden Douglas D. Fraser Guillaume Voiriot Maitray A. Patel Mark Daley Alexandre Elabbadi Aurélie Rousseau Yannis Prassas Matthieu Turpin Marina Marchetti Loula Papageorgiou Evangelos Terpos Meletios A. Dimopoulos Anna Falanga Jawed Fareed Muriel Fartoukh Ismail Elalamy |
| author_sort | Grigoris T. Gerotziafas |
| collection | DOAJ |
| description | In some patients, SARS-CoV-2 infection induces cytokine storm, hypercoagulability and endothelial cell activation leading to worsening of COVID-19, intubation and death. Prompt identification of patients at risk of intubation is an urgent need. Objectives. To derive a prognostic score for the risk of intubation or death in patients with COVID-19 admitted in intensive care unit (ICU), by assessing biomarkers of hypercoagulability, endothelial cell activation and inflammation and a large panel of clinical analytes. Design, Setting and Participants. A prospective, observational study enrolled 118 patients with COVID-19 admitted in the ICU. On the first day of ICU admission, all patients were assessed for biomarkers (protein C, protein S, antithrombin, D-Dimer, fibrin monomers, FVIIa, FV, FXII, FXII, FVIII, FvW antigen, fibrinogen, procoagulant phospholipid dependent clotting time, TFPI, thrombomodulin, P-selectin, heparinase, microparticles exposing TF, IL-6, complement C3a, C5a, thrombin generation, PT, aPTT, hemogram, platelet count) and clinical predictors. Main Outcomes and Measures. The clinical outcomes were intubation and mortality during hospitalization in ICU. Results: The intubation and mortality rates were 70% and 18%, respectively. The COMPASS-COVID-19-ICU score composed of P-Selectin, D-Dimer, free TFPI, TF activity, IL-6 and FXII, age and duration of hospitalization predicted the risk of intubation or death with high sensitivity and specificity (0.90 and 0.92, respectively). Conclusions and Relevance. COVID-19 is related to severe endothelial cell activation and hypercoagulability orchestrated in the context of inflammation. The COMPASS-COVID-19-ICU risk assessment model is accurate for the evaluation of the risk of mechanical ventilation and death in patients with critical COVID-19. The COMPASS-COVID-19-ICU score is feasible in tertiary hospitals and could be placed in the diagnostic procedure of personalized medical management and prompt therapeutic intervention. |
| first_indexed | 2024-03-09T19:45:35Z |
| format | Article |
| id | doaj.art-a170ba87aab34180bf4221b0d6d1c7cb |
| institution | Directory Open Access Journal |
| issn | 2673-6357 |
| language | English |
| last_indexed | 2024-03-09T19:45:35Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hemato |
| spelling | doaj.art-a170ba87aab34180bf4221b0d6d1c7cb2023-11-24T01:24:21ZengMDPI AGHemato2673-63572022-03-013120421810.3390/hemato3010017The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19Grigoris T. Gerotziafas0Patrick Van Dreden1Douglas D. Fraser2Guillaume Voiriot3Maitray A. Patel4Mark Daley5Alexandre Elabbadi6Aurélie Rousseau7Yannis Prassas8Matthieu Turpin9Marina Marchetti10Loula Papageorgiou11Evangelos Terpos12Meletios A. Dimopoulos13Anna Falanga14Jawed Fareed15Muriel Fartoukh16Ismail Elalamy17Research Team “Cancer-Hemostasis-Angiogenesis”, Research Group “Cancer Biology and Therapeutics”, Centre de Recherche Saint Antoine (CRSA), Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, 75012 Paris, FranceThrombosis and Haemostasis Centre, Biological Hematology Department, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, 75012 Paris, FranceLawson Health Research Institute, London, ON N6C 2R5, CanadaService de Médecine Intensive Réanimation, Hôpital Tenon, Département Médico-Universitaire APPROCHES, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, 75020 Paris, FranceDepartment of Computer Science, Western University, London, ON N6A 3K7, CanadaDepartment of Computer Science, Western University, London, ON N6A 3K7, CanadaService de Médecine Intensive Réanimation, Hôpital Tenon, Département Médico-Universitaire APPROCHES, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, 75020 Paris, FranceResearch Team “Cancer-Hemostasis-Angiogenesis”, Research Group “Cancer Biology and Therapeutics”, Centre de Recherche Saint Antoine (CRSA), Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, 75012 Paris, FranceDepartment of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, CanadaService de Médecine Intensive Réanimation, Hôpital Tenon, Département Médico-Universitaire APPROCHES, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, 75020 Paris, FranceImmunohematology and Transfusion Medicine Department, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyResearch Team “Cancer-Hemostasis-Angiogenesis”, Research Group “Cancer Biology and Therapeutics”, Centre de Recherche Saint Antoine (CRSA), Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, 75012 Paris, FranceDepartment of Clinical Therapeutics, Alexandra General Hospital, 11528 Athens, GreeceDepartment of Clinical Therapeutics, Alexandra General Hospital, 11528 Athens, GreeceImmunohematology and Transfusion Medicine Department, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, ItalyCardiovascular Research Institute, Loyola University Chicago Health Sciences Campus, Maywood, IL 60153, USAService de Médecine Intensive Réanimation, Hôpital Tenon, Département Médico-Universitaire APPROCHES, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, 75020 Paris, FranceResearch Team “Cancer-Hemostasis-Angiogenesis”, Research Group “Cancer Biology and Therapeutics”, Centre de Recherche Saint Antoine (CRSA), Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, 75012 Paris, FranceIn some patients, SARS-CoV-2 infection induces cytokine storm, hypercoagulability and endothelial cell activation leading to worsening of COVID-19, intubation and death. Prompt identification of patients at risk of intubation is an urgent need. Objectives. To derive a prognostic score for the risk of intubation or death in patients with COVID-19 admitted in intensive care unit (ICU), by assessing biomarkers of hypercoagulability, endothelial cell activation and inflammation and a large panel of clinical analytes. Design, Setting and Participants. A prospective, observational study enrolled 118 patients with COVID-19 admitted in the ICU. On the first day of ICU admission, all patients were assessed for biomarkers (protein C, protein S, antithrombin, D-Dimer, fibrin monomers, FVIIa, FV, FXII, FXII, FVIII, FvW antigen, fibrinogen, procoagulant phospholipid dependent clotting time, TFPI, thrombomodulin, P-selectin, heparinase, microparticles exposing TF, IL-6, complement C3a, C5a, thrombin generation, PT, aPTT, hemogram, platelet count) and clinical predictors. Main Outcomes and Measures. The clinical outcomes were intubation and mortality during hospitalization in ICU. Results: The intubation and mortality rates were 70% and 18%, respectively. The COMPASS-COVID-19-ICU score composed of P-Selectin, D-Dimer, free TFPI, TF activity, IL-6 and FXII, age and duration of hospitalization predicted the risk of intubation or death with high sensitivity and specificity (0.90 and 0.92, respectively). Conclusions and Relevance. COVID-19 is related to severe endothelial cell activation and hypercoagulability orchestrated in the context of inflammation. The COMPASS-COVID-19-ICU risk assessment model is accurate for the evaluation of the risk of mechanical ventilation and death in patients with critical COVID-19. The COMPASS-COVID-19-ICU score is feasible in tertiary hospitals and could be placed in the diagnostic procedure of personalized medical management and prompt therapeutic intervention.https://www.mdpi.com/2673-6357/3/1/17COVID-19hypercoagulabilityrisk assessmenthypercoagulabilityendothelial cellinflammation |
| spellingShingle | Grigoris T. Gerotziafas Patrick Van Dreden Douglas D. Fraser Guillaume Voiriot Maitray A. Patel Mark Daley Alexandre Elabbadi Aurélie Rousseau Yannis Prassas Matthieu Turpin Marina Marchetti Loula Papageorgiou Evangelos Terpos Meletios A. Dimopoulos Anna Falanga Jawed Fareed Muriel Fartoukh Ismail Elalamy The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 Hemato COVID-19 hypercoagulability risk assessment hypercoagulability endothelial cell inflammation |
| title | The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 |
| title_full | The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 |
| title_fullStr | The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 |
| title_full_unstemmed | The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 |
| title_short | The COMPASS-COVID-19-ICU Study: Identification of Factors to Predict the Risk of Intubation and Mortality in Patients with Severe COVID-19 |
| title_sort | compass covid 19 icu study identification of factors to predict the risk of intubation and mortality in patients with severe covid 19 |
| topic | COVID-19 hypercoagulability risk assessment hypercoagulability endothelial cell inflammation |
| url | https://www.mdpi.com/2673-6357/3/1/17 |
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