PB0886 - Acute phase reactants proteins (APRPs) in COVID-19: association with VTE and mortality.

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Maria Rita Peralta, MD

Haemostasis&Thrombosis Consultant
St Thomas Hospital & Royal Brompton Hospital, London, UK
LONDON, England, United Kingdom

Co-Author(s)

VM

Vincent Muczynski

Research Associate
Research Department of Haematology, University College London (UCL)
London, England, United Kingdom
PL

Philip Lane

Research Scientist
Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
London, England, United Kingdom
AR

Anne Riddell

Laboratory Manager
Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
London, England, United Kingdom
SB

Sanjay Bhagani

Professor in Infectious Disease
Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
London, England, United Kingdom
BA

Banwari Agarwal

Professor of Liver Intensive Care Medicine
Department of Intensive Care, Royal Free London NHS Foundation Trust, London, UK
London, England, United Kingdom
Pratima Chowdary, MD

Professor of Haemophilia, Centre Director
Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital
London, England, United Kingdom

Background: Acute-phase reaction proteins (APRPs) are reactive proteins, which are directly manifested as part of the body's stress response. They are non-specific markers of inflammation and can be classified as positive or negative, depending on their serum concentrations during inflammation.

Aims: Identify APRPs associated with poor outcomes: Venous thromboembolic events (VTE) and death.

Methods: Cross-sectional study, ethically approved, including 151 unvaccinated COVID-19 patients,16 healthy volunteers (HVs) and 10 ICU-control sampled admitted to Royal Free and Barnet Hospital London between April 15 and May 31, 2020. 16 APRPs were investigated by multiplex assays and statistical analysis (Mann-Whitney u test) performed to characterise the inflammatory profile of COVID-19 patients.

Results: Of 151 COVID-19 patients recruited 19 did not survive and 49 developed VTE. Comparing the non-survivors to the survivors it was found that the positive APRPs: fibrinogen, FVIII, VWF:Ag, haptoglobin, ferritin, CRP changes were associated with death, p value ranging from < 0.0001 to 0.02. Among the negative APRPs: ADAMST13, ATIII, albumin, retinol binding protein 4 (RBP4) were associated with death, p value ranging from < 0.0001 to 0.0007. Comparing the VTE patients to the non-VTE patients it was found that among the positive acute phase reactants fibrinogen, FVIII, vWF;ag, haptoglobin, CRP, serum amyloid P (SAP), α1-acid glycoprotein (AGP), lactoferrin and C5, were associated with VTE, p value ranging from < 0.0001 to < 0.01.

Conclusion(s): COVID-19 continues to affect populations worldwide. It triggers an immune response in infected individuals which causes APRPs release. Various significantly elevated APRPs were associated with poor outcomes and therefore have potential to be used as severity prediction biomarkers. This information reinforces the already known COVID-19 inflammatory status and thus encourage a better allocation of resources and triage planning, ensuring that patients in need to critical care are receiving it.