Immunostimulation and Coagulopathy in COVID-19 Compared to Patients With H1N1 Pneumonia or Bacterial Sepsis

• Published in: In vivo (Athens) 2022-03, Vol.36 (2), p.954-960
• Main Authors: Papadakis, Dimitrios-Dorotheos, Politou, Marianna, Kompoti, Maria, Vagionas, Dimitrios, Kostakou, Eirini, Theodoulou, Danai, Kaniaris, Evangelos, Rovina, Nikoletta, Panayiotakopoulos, George, Dimopoulos, Stavros, Koutsoukou, Antonia, Vasileiadis, Ioannis
• Format: Article
• Language: English
• Subjects: Blood Coagulation Disorders - etiology; COVID-19 - complications; Humans; Immunization; Influenza A Virus, H1N1 Subtype; SARS-CoV-2; Sepsis - complications
• ISSN: 0258-851X; 1791-7549
• DOI: 10.21873/INVIVO.12786

Multiple reports from all over the world link COVID-19 with endothelial/coagulation disorders as well as a dysregulated immune response. This study tested the hypothesis that immunostimulation will be greater in COVID-19 patients than in patients with H1N1 infection or bacterial sepsis. Also, whether an increase in immune stimulation will be accompanied by a more severely affected endothelium/coagulation system was examined. Twenty-three septic patients, admitted in the Intensive Care Unit (ICU), were enrolled (9 with SARS-CoV-2, 5 with H1N1 pneumonia, 9 with bacterial sepsis). Myeloperoxidase (MPO) activity along with certain endothelial/coagulation factors were assessed on admission (time point 1) and at either improvement or deterioration (time point 2). MPO levels were significantly higher in COVID-19 patients compared to both other groups. Furthermore, in patients with COVID-19, vWF levels did not differ significantly, fVIII levels were lower while ADAMTS-13 activity was higher compared to patients with H1N1 pneumonia and bacterial sepsis (a trend in the latter). Increased immunostimulation was noted in COVID-19 patients compared to other septic patients; however, this was not accompanied by greater disturbance of the clotting system and/or more severe endothelial injury.