# Combined coagulation and inflammation markers as predictors of venous thrombo-embolism and death in COVID-19

## TL;DR

This study shows that combining coagulation and inflammation markers can better predict severe outcomes like blood clots and death in COVID-19 patients.

## Contribution

The study introduces a novel approach combining coagulation and inflammatory biomarkers to predict severe outcomes in COVID-19.

## Key findings

- 39 patients (23.3%) developed venous thrombo-embolism and 30 (18%) died.
- High levels of CRP, IL-6, D-dimers, and low ADAMTS13 activity were significant predictors of severe outcomes.
- Combining coagulation and inflammation markers improves prognostication of severe disease outcomes.

## Abstract

The COVID-19 pandemic related to SARS-CoV-2 virus was responsible for global pandemic. The severe form of the disease was linked to excessive activation of immune pathways together with a systemic cytokine storm response and thrombotic venous or arterial complications. Factors predicting severe outcomes including venous and/or pulmonary thrombosis (VT) and death were identified, but the prognostic role of their combination was not addressed extensively.

We investigated the role of prognostic factors from the coagulation or inflammatory pathways to better understand the outcome of the disease.

For this, we prospectively studied 167 SARS-CoV-2-positive patients from admission in intensive care units (ICU) or emergency departments from four academic hospitals over a 14-month period. Besides standard biology, we assessed serum concentrations of inflammatory markers, coagulation factors and peripheral blood cells immunophenotyping.

Thirty-nine patients (23.3%) developed VT and 30 patients (18%) died. By univariate analysis, C-reactive protein (CRP) level > 150 mg/L, interleukin-6 (IL-6) ≥ 20 pg/mL, D-dimers > 1,500 μg/L, ADAMTS13 activity ≤ 50%, Von

A combination of coagulation and inflammatory markers can refine the prognostication of severe outcome in COVID-19, and could be useful for the initial evaluation of other types of viral infection.