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dc.contributor.authorUeland, Thor
dc.contributor.authorMichelsen, Annika Elisabet
dc.contributor.authorTveita, Anders
dc.contributor.authorKåsine, Trine
dc.contributor.authorDahl, Tuva Børresdatter
dc.contributor.authorFinbråten, Ane-Kristine
dc.contributor.authorHolten, Aleksander Rygh
dc.contributor.authorSkjønsberg, Ole Henning
dc.contributor.authorMathiessen, Alexander
dc.contributor.authorNezvalova-Henriksen, Katerina
dc.contributor.authorTrøseid, Marius
dc.contributor.authorAaløkken, Trond Mogens
dc.contributor.authorHalvorsen, Bente
dc.contributor.authorDyrhol-Riise, Anne Ma
dc.contributor.authorBarratt-Due, Andreas
dc.contributor.authorAukrust, Pål
dc.date.accessioned2024-03-19T14:29:45Z
dc.date.available2024-03-19T14:29:45Z
dc.date.issued2023-12-07
dc.description.abstractBackground - Several studies have examined parameters of increased thrombogenicity in COVID-19, but studies examining their association with long-term outcome and potential effects of antiviral agents in hospitalized patients with COVID-19 are scarce.<p> <p>Objectives - To evaluate plasma levels of hemostatic proteins during hospitalization in relation to disease severity, treatment modalities, and persistent pulmonary pathology after 3 months.<p> <p>Methods - In 165 patients with COVID-19 recruited into the NOR-Solidarity trial (NCT04321616) and randomized to treatment with hydroxychloroquine, remdesivir, or standard of care, we analyzed plasma levels of hemostatic proteins during the first 10 days of hospitalization (n = 160) and at 3 months of follow-up (n = 100) by enzyme immunoassay.<p> <p>Results - Our main findings were as follows: (i) tissue plasminogen activator (tPA) and tissue factor pathway inhibitor (TFPI) were increased in patients with severe disease (ie, the combined endpoint of respiratory failure [Po2-to-FiO2 ratio, <26.6 kPa] or need for treatment at an intensive care unit) during hospitalization. Compared to patients without severe disease, tPA levels were a median of 42% (P < .001), 29% (P = .002), and 36% (P = .015) higher at baseline, 3 to 5 days, and 7 to 10 days, respectively. For TFPI, median levels were 37% (P = .003), 25% (P < .001), and 10% (P = .13) higher in patients with severe disease at these time points, respectively. No changes in thrombin-antithrombin complex; alpha 2-antiplasmin; a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13; or antithrombin were observed in relation to severe disease. (ii) Patients treated with remdesivir had lower levels of TFPI than those in patients treated with standard of care alone. (iii) TFPI levels during hospitalization, but not at 3 months of follow-up, were higher in those with persistent pathology on chest computed tomography imaging 3 months after hospital admission than in those without such pathology. No consistent changes in thrombin-antithrombin complex, alpha 2-antiplasmin, ADAMTS-13, tPA, or antithrombin were observed in relation to pulmonary pathology at 3 months of follow-up.<p> <p>Conclusion - TFPI and tPA are associated with severe disease in hospitalized patients with COVID-19. For TFPI, high levels measured during the first 10 days of hospitalization were also associated with persistent pulmonary pathology even 3 months after hospital admittance.en_US
dc.identifier.citationUeland, Michelsen, Tveita, Kåsine, Dahl, Finbråten, Holten, Skjønsberg, Mathiessen, Nezvalova-Henriksen, Trøseid, Aaløkken, Halvorsen, Dyrhol-Riise, Barratt-Due, Aukrust. Coagulopathy and adverse outcomes in hospitalized patients with COVID-19: results from the NOR-Solidarity trial. Research and Practice in Thrombosis and Haemostasis (RPTH). 2023;8(1)
dc.identifier.cristinIDFRIDAID 2245177
dc.identifier.doi10.1016/j.rpth.2023.102289
dc.identifier.issn2475-0379
dc.identifier.urihttps://hdl.handle.net/10037/33192
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalResearch and Practice in Thrombosis and Haemostasis (RPTH)
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)en_US
dc.titleCoagulopathy and adverse outcomes in hospitalized patients with COVID-19: results from the NOR-Solidarity trialen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)