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Poster Networking

Vascular Biology, Blood Cells, and Immunothrombosis

PB1376 - Plasminogen activator inhibitor- 1 (PAI-1) as an early marker of COVID-19 severity in patients with high fibrosis-4 index

Tuesday, June 25, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall

    Co-Author(s)

  • MR

    Mickael Rosa

    Assistant professor
    CHRU Lille
    Lille, Nord-Pas-de-Calais, France

    • Presenting Author(s)

  • AD

    Annabelle Dupont

    professor
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, F5900 Lille
    59000 Lille, Nord-Pas-de-Calais, France

    • Co-Author(s)

  • DD

    David Dombrowicz

    Director of Research
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, F-59000 Lille, France
    Lille, Nord-Pas-de-Calais, France

  • AR

    Antoine Rauch

    MD, Professor of Hematology
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, F-59000 Lille, France
    Lille, Nord-Pas-de-Calais, France

  • CK

    Caroline Kitel

    Biologist
    Lille University Hospital
    Lille, Nord-Pas-de-Calais, France

  • EJ

    Emmanuelle Jeanpierre

    PharmD
    CHU Lille, Service d'Hemostase et Transfusion - Lille FRANCE
    Lille, Nord-Pas-de-Calais, France

  • JL

    Julien Labreuche

    Ingeneer
    Department of Biostatistics, Centre Hospitalier Universitaire Lille, Lille, France
    lille, Nord-Pas-de-Calais, France

  • LM

    Lea Mortain

    Ingeneer
    Department of Biostatistics, Centre Hospitalier Universitaire Lille, Lille, France
    Lille, Nord-Pas-de-Calais, France

  • AM

    Anne Muhr-Tailleux

    professor
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, F-59000 Lille, France
    Lille, Nord-Pas-de-Calais, France

  • eV

    emmanuelle Vallez

    Ingeneer
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, F-59000 Lille, France
    Lille, Nord-Pas-de-Calais, France

  • Jp

    Julien poissy

    Professor, intensive care
    Lille University Hospital
    lille, Nord-Pas-de-Calais, France

  • DG

    Delphine Garrigue

    Anesthesiologist
    Lille University Hospital
    Lille, Nord-Pas-de-Calais, France

  • EK

    Eric Kipnis

    Professor, Anesthesiology
    Lille University Hospital
    lille, Nord-Pas-de-Calais, France

  • DD

    Dominique Deplanque

    Professor, Head of clinical research center
    Univ. Lille, Inserm, CHU Lille,
    lille, Nord-Pas-de-Calais, France

  • David-Alexandre Trégouët

    Senior Investigator
    Bordeaux Population Health research Center, Inserm U1219, Bordeaux University
    Bordeaux, Aquitaine, France

  • BS

    Bart Staels

    Head of Unit
    Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011- EGID, F-59000 Lille, France
    lille, Nord-Pas-de-Calais, France

  • SS

    Sophie Susen, PhD,MD

    Professor of Haematology
    Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, France
    Lille, Nord-Pas-de-Calais, France

Background: COVID-19 infection can rapidly progress to severe disease and death. Early identification of patients at higher risk of unfavourable COVID-19 is a major issue to optimise patients care. The fibrosis-4(FIB-4) index, developed to predict fibrosis in liver disease, appears significantly associated with COVID-19 severity, independently on pre-existing liver disease.

Aims: To investigate, at hospital admission, the associations between circulating markers related to inflammation, endotheliopathy and liver injury and COVID-19 severity, according to FIB-4 index.

Methods: We included COVID-19 patients admitted to the emergency department of a French tertiary hospital between March 5, 2020 and February 28, 2021. At admission, blood samples were collected and FIB-4 score was evaluated. The main outcome was COVID-19 severity defined by intensive care unit hospitalization and/or death within 28 days from hospital admission. Study protocol was approved by an ethics committee. All participants provided informed consent.

Results: A total of 1178 patients were included (57% of male, mean age: 59.7 years), 306 (26%) and 422 (36%) patients had high and low FIB-4 index (>3.25, < 1.45), respectively. High FIB-4 index patients presented higher risk to develop severe COVID-19 compared to low FIB-4 index patients (41 versus 17%, p< 0.0001). After adjustment for age, sex, BMI, diabetes, hypertension and corticosteroid therapy in high FIB-4 index patients, COVID-19 severity was associated to makers of inflammation (IL2RA, IL6, TNF), endotheliopathy (Von Willebrand factor, syndecan, antithrombin, PAI-1) and liver injury (serum amyloid A (SAA), ferritin, M30, HDL, LDL, triglycerides, apolipoprotein D and E) and multivariate analysis revealed high PAI-1 and sIL2R and low HDL concentrations as independent factors for severe COVID-19 (Table 1).

Conclusion(s): This study demonstrates in large cohort of COVID-19 patients that PAI-1, an important regulator of fibrinolysis, could help to early stratify COVID-19 severity in a population at high risk and may be a useful target for future therapeutic strategies.