Current and novel biomarkers of thrombotic risk in COVID-19: a Consensus Statement from the International COVID-19 Thrombosis Biomarkers Colloquium.

Current and novel biomarkers of thrombotic risk in COVID-19: a Consensus Statement from the International COVID-19 Thrombosis Biomarkers Colloquium.
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DOI:
10.1038/s41569-021-00665-7
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发表时间:
2022-07
期刊:
Nature reviews. Cardiology
影响因子:
--
通讯作者:
Becker RC
Becker RC
中科院分区:
其他
文献类型:
--
作者:
Gorog DA;Storey RF;Gurbel PA;Tantry US;Berger JS;Chan MY;Duerschmied D;Smyth SS;Parker WAE;Ajjan RA;Vilahur G;Badimon L;Berg JMT;Cate HT;Peyvandi F;Wang TT;Becker RC

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由于过度炎症、内皮细胞活化和损伤、血小板活化和高凝状态,2019冠状病毒病(COVID-19)使患者易于发生血栓形成和血栓栓塞事件。COVID-19患者具有血栓前或血栓形成状态,血栓形成的几种生物标志物水平升高,这与疾病严重程度和预后相关。尽管在大流行期间早期发现了COVID-19相关凝血病的一些生物标志物,包括高水平的纤维蛋白原和d-二聚体,但COVID-19血栓形成风险的许多新生物标志物已经出现。在这份共识声明中,我们描述了COVID-19的血栓形成特征,并提出了最新的生物标志物和平台来评估这些患者的血栓形成风险,包括血小板活化、血小板聚集、内皮细胞活化或损伤、凝血和纤溶的标志物,以及新认识到的疫苗后血栓形成伴血小板减少综合征的生物标志物。然后,我们对这些生物标志物的临床应用提出了共识建议,以告知预后,评估疾病的严重程度,预测血栓形成风险和住院死亡率。对这些生物标志物的深入了解可能有助于危险分层和分类,指导干预措施,并为未来的研究提供平台。在这份共识声明中,作者描述了COVID-19的血栓形成特征,并提出了最新的生物标志物和平台,以评估这些患者的血栓形成风险。关于这些生物标志物的临床应用,提出了共识建议,以告知预后,评估疾病的严重程度,并预测血栓形成和住院死亡率。
Coronavirus disease 2019 (COVID-19) predisposes patients to thrombotic and thromboembolic events, owing to excessive inflammation, endothelial cell activation and injury, platelet activation and hypercoagulability. Patients with COVID-19 have a prothrombotic or thrombophilic state, with elevations in the levels of several biomarkers of thrombosis, which are associated with disease severity and prognosis. Although some biomarkers of COVID-19-associated coagulopathy, including high levels of fibrinogen and d-dimer, were recognized early during the pandemic, many new biomarkers of thrombotic risk in COVID-19 have emerged. In this Consensus Statement, we delineate the thrombotic signature of COVID-19 and present the latest biomarkers and platforms to assess the risk of thrombosis in these patients, including markers of platelet activation, platelet aggregation, endothelial cell activation or injury, coagulation and fibrinolysis as well as biomarkers of the newly recognized post-vaccine thrombosis with thrombocytopenia syndrome. We then make consensus recommendations for the clinical use of these biomarkers to inform prognosis, assess disease acuity, and predict thrombotic risk and in-hospital mortality. A thorough understanding of these biomarkers might aid risk stratification and prognostication, guide interventions and provide a platform for future research. In this Consensus Statement, the authors delineate the thrombotic signature of COVID-19 and present the latest biomarkers and platforms to assess thrombotic risk in these patients. Consensus recommendations are made about the clinical use of these biomarkers to inform prognosis, assess disease acuity, and predict thrombosis and in-hospital mortality.
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