Validation of an admission coagulation panel for risk stratification of COVID-19 patients.
<h4>Background</h4>There is limited data on the markers of coagulation and hemostatic activation (MOCHA) profile in Coronavirus disease 2019 (COVID-19) and its ability to identify COVID-19 patients at risk for thrombotic events and other complications.<h4>Methods</h4>Hospital...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248230&type=printable |
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| author | Darwish Alabyad Srikant Rangaraju Michael Liu Rajeel Imran Christine L Kempton Milad Sharifpour Sara C Auld Manila Gaddh Roman Sniecinski Cheryl L Maier Jeannette Guarner Alexander Duncan Fadi Nahab |
| author_facet | Darwish Alabyad Srikant Rangaraju Michael Liu Rajeel Imran Christine L Kempton Milad Sharifpour Sara C Auld Manila Gaddh Roman Sniecinski Cheryl L Maier Jeannette Guarner Alexander Duncan Fadi Nahab |
| author_sort | Darwish Alabyad |
| collection | DOAJ |
| description | <h4>Background</h4>There is limited data on the markers of coagulation and hemostatic activation (MOCHA) profile in Coronavirus disease 2019 (COVID-19) and its ability to identify COVID-19 patients at risk for thrombotic events and other complications.<h4>Methods</h4>Hospitalized patients with confirmed SARS-COV-2 from four Atlanta hospitals were included in this observational cohort study and underwent admission testing of MOCHA parameters (plasma d-dimer, prothrombin fragment 1.2, thrombin-antithrombin complex, fibrin monomer). Clinical outcomes included deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic stroke, access line thrombosis, ICU admission, intubation and mortality.<h4>Main results</h4>Of 276 patients (mean age 59 ± 6.4 years, 47% female, 62% African American), 45 (16%) had a thrombotic endpoint. Each MOCHA parameter was independently associated with a thrombotic event (p<0.05) and ≥ 2 abnormalities was associated with thrombotic endpoints (OR 3.3, 95% CI 1.2-8.8) as were admission D-dimer ≥ 2000 ng/mL (OR 3.1, 95% CI 1.5-6.6) and ≥ 3000 ng/mL (OR 3.6, 95% CI 1.6-7.9). However, only ≥ 2 MOCHA abnormalities were associated with ICU admission (OR 3.0, 95% CI 1.7-5.2) and intubation (OR 3.2, 95% CI 1.6-6.4). MOCHA and D-dimer cutoffs were not associated with mortality. MOCHA with <2 abnormalities (26% of the cohort) had 89% sensitivity and 93% negative predictive value for a thrombotic endpoint.<h4>Conclusions</h4>An admission MOCHA profile is useful to risk-stratify COVID-19 patients for thrombotic complications and more effective than isolated d-dimer for predicting risk of ICU admission and intubation. |
| format | Article |
| id | doaj-art-b8dc30ff903542929bd50ffae83b2308 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-b8dc30ff903542929bd50ffae83b23082025-08-20T02:17:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024823010.1371/journal.pone.0248230Validation of an admission coagulation panel for risk stratification of COVID-19 patients.Darwish AlabyadSrikant RangarajuMichael LiuRajeel ImranChristine L KemptonMilad SharifpourSara C AuldManila GaddhRoman SniecinskiCheryl L MaierJeannette GuarnerAlexander DuncanFadi Nahab<h4>Background</h4>There is limited data on the markers of coagulation and hemostatic activation (MOCHA) profile in Coronavirus disease 2019 (COVID-19) and its ability to identify COVID-19 patients at risk for thrombotic events and other complications.<h4>Methods</h4>Hospitalized patients with confirmed SARS-COV-2 from four Atlanta hospitals were included in this observational cohort study and underwent admission testing of MOCHA parameters (plasma d-dimer, prothrombin fragment 1.2, thrombin-antithrombin complex, fibrin monomer). Clinical outcomes included deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic stroke, access line thrombosis, ICU admission, intubation and mortality.<h4>Main results</h4>Of 276 patients (mean age 59 ± 6.4 years, 47% female, 62% African American), 45 (16%) had a thrombotic endpoint. Each MOCHA parameter was independently associated with a thrombotic event (p<0.05) and ≥ 2 abnormalities was associated with thrombotic endpoints (OR 3.3, 95% CI 1.2-8.8) as were admission D-dimer ≥ 2000 ng/mL (OR 3.1, 95% CI 1.5-6.6) and ≥ 3000 ng/mL (OR 3.6, 95% CI 1.6-7.9). However, only ≥ 2 MOCHA abnormalities were associated with ICU admission (OR 3.0, 95% CI 1.7-5.2) and intubation (OR 3.2, 95% CI 1.6-6.4). MOCHA and D-dimer cutoffs were not associated with mortality. MOCHA with <2 abnormalities (26% of the cohort) had 89% sensitivity and 93% negative predictive value for a thrombotic endpoint.<h4>Conclusions</h4>An admission MOCHA profile is useful to risk-stratify COVID-19 patients for thrombotic complications and more effective than isolated d-dimer for predicting risk of ICU admission and intubation.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248230&type=printable |
| spellingShingle | Darwish Alabyad Srikant Rangaraju Michael Liu Rajeel Imran Christine L Kempton Milad Sharifpour Sara C Auld Manila Gaddh Roman Sniecinski Cheryl L Maier Jeannette Guarner Alexander Duncan Fadi Nahab Validation of an admission coagulation panel for risk stratification of COVID-19 patients. PLoS ONE |
| title | Validation of an admission coagulation panel for risk stratification of COVID-19 patients. |
| title_full | Validation of an admission coagulation panel for risk stratification of COVID-19 patients. |
| title_fullStr | Validation of an admission coagulation panel for risk stratification of COVID-19 patients. |
| title_full_unstemmed | Validation of an admission coagulation panel for risk stratification of COVID-19 patients. |
| title_short | Validation of an admission coagulation panel for risk stratification of COVID-19 patients. |
| title_sort | validation of an admission coagulation panel for risk stratification of covid 19 patients |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248230&type=printable |
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