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?:abstract
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BACKGROUND: Hypercoagulability seems to contribute to SARS‐CoV‐2 pneumonia pathogenesis. However, age and metabolic syndrome are potential cofounders when assessing the value of coagulation biomarkers prediction of COVID‐19 outcomes. We assessed whether coagulation biomarkers, including FVIII and VWF levels, measured at time of admission were predictive of COVID‐19 adverse outcomes irrespective of age and major comorbidities associated with metabolic syndrome. METHODS: Blood was sampled at admission in 243 adult COVID‐19 patients for analysis of coagulation biomarkers including FVIII and VWF on platelet‐poor plasma. The association between baseline CRP, aPTT ratio, PT ratio, D‐dimers, fibrinogen, FVIII, VWF:Ag and FVIII/VWF:Ag ratio levels and adverse outcomes (increased oxygen requirements, thrombosis and death at day‐30) was assessed by regression analysis after adjustment on age, sex, body mass index, diabetes and hypertension. RESULTS: In univariable regression analysis increased CRP (SHR, 1.68; 95%CI, 1.26 to 2.23), increased fibrinogen (SHR, 1.32; 95% CI, 1.04 to 1.68) and decreased FVIII/VWF:Ag ratio (SHR, 0.70 ; 95% CI, 0.52‐0.96) levels at admission were significantly associated with the risk of increased oxygen requirement during follow‐up. Leucocytes (SHR, 1.36; 95%CI, 1.04 to 1.76), platelets (SHR,1.71; 95%CI, 1.11 to 2.62), D‐dimers (SHR, 2.48; 95%CI, 1.66 to 3.78), FVIII (SHR, 1.78; 95%CI, 1.17 to 2.68) were associated with early onset of thrombosis after admission. After adjustment for age, sex, BMI, hypertension and diabetes, these associations were not modified. CONCLUSION: Coagulation biomarkers are early and independent predictors of increased oxygen requirement in COVID‐19 patients.
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