PB0072 - Thrombin generation potential and the risk of severe COVID-19 infection

Sunday, June 25, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Willian J. van Dijk, MD (he/him/his)

PhD student
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
Vlaardingen, Zuid-Holland, Netherlands

Co-Author(s)

KF

Konstantin Föhse

Researcher
Radboud University Medical Center Nijmegen
Nijmegen, Gelderland, Netherlands
MN

Mihai Netea

Professor
Radboud University Medical Center Nijmegen
Nijmegen, Gelderland, Netherlands
Hv

Henri C.H. van Werkhoven

Assistant Professor
Utrecht Medical Center
Utrecht, Utrecht, Netherlands
MB

Marc MJM Bonten

Professor
| Julius Center for Health Sciences and Primary Care, Dept Epidemiology, Program: Infectious Diseases University Medical Center Utrecht
Utrecht, Utrecht, Netherlands
MG

Martin Grobusch

Professor
Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center
Amsterdam, Noord-Holland, Netherlands
Mv

Maurice A.A.J. van den Bosch

Professor
OLVG, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands
FR

Frits R. R. Rosendaal

Professor
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands
Astrid van Hylckama Vlieg, PhD

Associate Professor
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Leiden, Zuid-Holland, Netherlands

Background: COVID-19 is associated with a wide variety of disease severity. Given coagulation disorders are frequently reported in SARS-CoV-2 infections, a possible marker for severe COVID-19 could be thrombin generation potential (TGP).

Aims: To determine the association between TGP and the risk of test-confirmed COVID-19 infection as well as with a severe course of COVID-19 infection.

Methods: This study was embedded in the BCG-PRIME study, a randomized controlled trail that aimed to assess whether BCG vaccination was associated with a reduced risk of (severe) COVID-19 infection in community-dwelling adults over 60 years of age with chronic somatic comorbidity or recent hospitalization or major surgery. In participants not using anticoagulants, TGP was determined prior to BCG or placebo vaccination. Participants were followed for six months, using app-based self-monitoring, and national databases on test results and healthcare use. Severe COVID-19 was defined as the need for healthcare interventions (such as the need for antibiotics or steroids; hospital admission, ICU admission) or COVID-19 related death. Peak height of the TGP was analyzed as the primary endpoint and hazard ratios (HR) were estimated with Cox regression after stratification of the peak height at the median of the distribution, and were adjusted for age, sex, BMI, frailty, and comorbidities. Informed consent was obtained and this study protocol was approved by the local medical ethical committee.

Results: Within the 1148 included participants, 59 had a positive SARS-CoV-2 test during follow-up of whom 19 experienced severe COVID-19. The HR of a COVID-19 infection in participants with a high TGP compared with a low TGP was 0.9 (95% confidence interval (CI) 0.5-1.5). For severe COVID-19 the HR was 1.6 (95% CI 0.6 – 4.1). Other TGP markers were not associated with (severe) COVID-19.

Conclusion(s): Thrombin generation potential was not associated with the risk of COVID-19 infection, but possibly with a severe outcome.