Role of Thromboinflammation Interaction in the Serious-Critical COVID-19 Pneumonia: A Single-center Retrospective Study

Abstract

AbstractAimTo describe the potential role of thromboinflammation in thromboembolism and the progress of coronavirus disease 2019 (COVID-19).MethodsThe retrospective study included sequentially hospitalized patients with the diagnosis of COVID-19 pneumonia during the first pandemic (December 1, 2022, to January 31, 2023) at a medical center in Beijing, China. Risks of critical medical support requirements, thrombosis events, and death were valued in the multivariate logistic regression models, where age (≥ 80 vs. < 80 years old), nadir platelets level (≤100 vs. > 100 10^9/L), C-reactive protein (CRP) level at admission (≥ 80 vs. < 80 mg/L), D-dimer level at admission (≥ 1.0 vs. < 1.0 mg/L) were dichotomized.ResultsA total of 88 patients were included (median age 77 years, 72% male). During hospitalization, 35 (40%) patients required critical medical support, 22 (29%) had disseminated intravascular coagulation (DIC), 11 (13%) had radiologically supported thrombosis events, and 26 (30%) died. Increased age (odds ratio [OR]: 5.22,95% confidence interval [CI]: 1.27-21.53;p=0.02), elevated CRP levels (OR: 9.26, 95% CI: 2.24-38.37;p<0.01), decreased nadir platelet level (OR: 13.47, 95% CI: 1.91-94.84;p<0.01), elevated D-dimer level (OR: 5.21, 95 CI%: 0.96-28.21;p=0.06) were associated with the requirements of critical care. Increased age (OR: 10.87, 95% CI: 3.05-38.80;p<0.01), elevated CRP levels (OR: 6.14, 95% CI:1.68-22.47;p<0.01), decreased nadir platelet levels (OR: 5.96, 95% CI: 1.34-26.47;p=0.02) and D-dimers (≥1.0 vs. <1.0 mg/L, OR: 2.26, 95% CI: 0.68-7.44;p=0.18) were associated with death. Increased age (OR: 2.40,95% CI: 0.60-9.67;p=0.22), decreased nadir platelet levels (OR: 1.31, 95% CI: 0.22-7.96;p=0.77), inflmmation status, including D-dimers (≥1.0 vs. <1.0 mg/L, OR:4.62, 95% CI: 0.89-24.04;p=0.07) and CRP (≥80 vs. <80 mg/mL, OR:5.44, 95% CI: 1.05-28.27;p=0.04) were significantly associated with the risks of thromboembolism.ConclusionsThe retrospective study indicated thromboinflammation promoted thromboembolism and was associated with the outcomes of COVID-19 pneumonia.