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    Poster Networking

    COVID

    Poster Networking Session

    PB0056 - Predicting VTE and mortality in COVID-19 by Receiver-operating characteristic (ROC) analysis of haemostatic and inflammatory biomarkers

    Sunday, June 25, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Presenting Author(s)

    • Maria Rita Peralta, BACHELOR

      Haematology Consultant
      St Thomas hospital London NHS Foundation Trust. London, United Kingdom
      LONDON, England, United Kingdom

      • Co-Author(s)

    • Vincent Muczynski, PhD (he/him/his)

      Research Fellow
      University College London (UCL)
      London, England, United Kingdom

    • PL

      Philip Lane

      Biomedical scientist
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
      London, England, United Kingdom

    • LP

      Liezelle Pagala

      Biomedical scientist
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
      London, England, United Kingdom

    • AR

      Anne Riddell

      Laboratory Head of Department (Special Coagulation, Haemophilia) and HSL Scientific Lead Coagulation
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK
      London, England, United Kingdom

    • Sb

      Sanjay bhagani

      Consultant Physician/Hon.Associate Professor Department of Infectious Disease/HIV Medicine
      Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • BA

      Banwari Agarwal

      Consultant at the Department of Critical Care, Royal Free Hospital,London
      Department of Intensive care and Anaesthesia, Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • AD

      Anja Drebes

      Consultant Haematologist
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
      London, England, United Kingdom

    • John H. McVey, PhD

      Professor of Cardiovascular Biology, University of Surrey
      Department of Biomedical Sciences, University of Surrey, Guilford, UK
      Guilford, England, United Kingdom

    • TK

      Tushar Kotecha

      Consultant Cardiologist
      Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • DH

      Derralyn Hughes

      Professor of experimental Haematology at UCL, london
      Research Department of Haematology, University College London (UCL)
      London, England, United Kingdom

    • DM

      Daniel Martin

      Professor of Perioperative and Intensive Care Medicine
      Department of Intensive care and Anaesthesia, Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • AD

      Andrew Davenport

      Professor of Dialysis&ICU Nephrology UCL Department of Nephrology
      Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • TS

      Tara Sood

      Consultant in Emergency Medicine
      Royal Free London NHS Foundation Trust, London, UK
      London, England, United Kingdom

    • LL

      Lesley Lanning

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

    • TG

      Tejas Gandhi

      Biomedical scientist
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
      London, England, United Kingdom

    • PC

      Pratima Chowdary, MD

      Consultant Haematologist
      Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust, London, United Kingdom
      London, England, United Kingdom

    Background: Death and venous thromboembolic events (VTE) represent significant complications in the COVID-19 infection. The receiver-operating characteristic (ROC) curves are a graphical method for displaying sensitivity and specificity of a continuous biomarker for a binary disease outcome.

    Aims: This analysis aimed to investigate haemostatic, endothelium/angiogenesis and inflammatory/cytokines biomarkers as predictors of mortality and VTE by ROC analysis.

    Methods: A cross-sectional study enrolled unvaccinated COVID-19 patients aged over 18 reviewed at Royal Free Hospital and Barnet Hospital in London between April 15th and May 31st, 2020. Ethical approval was obtained to bleed patients both with and without capacity. 146 biomarkers were measured in plasma and ROC performed to identify biomarkers sensitive to VTE and death.

    Results: 151 patients were enrolled, 82 males, 69 females of whom 19 died and 49 developed VTE. Amongst the haemostatic parameters FVIII, vWF: Ag. ADAMST13, protein C, antithrombin, d-dimer, FXIII, t-pa and plasminogen changes were associated with death with an AUC (area under the curve) between 0.7 and 0.8, (p value ranging from 0.01 to < 0.0001]. Among the endothelial markers none of them had an AUC ≥ 0.7, apart from TFPI (AUC 0.8, p value 0.0001). The inflammatory/cytokines markers sensitive to death were albumin, IL-6, sIL-2Ra, CRP, WBC, C5, osteopontin, EMMPIRIN, HGF (hepatocyte growth factor) with an AUC ≥ 0.7 and a p-value ranging from 0.0012 to < 0.0001. Comparing the VTE vs non-VTE fibrinogen, d-dimer, vWF: Ag and ADAMST 13 were associated with VTE, ROC ≥ 0.7 and p value ranging from 0.01 to < 0.0001.The inflammatory/cytokines markers sensitive to VTE were CRP, WBC, osteopontin, C5 and EMMPIRIN with an AUC of 0.7.

    Conclusion(s): Our study identified that haemostatic and inflammatory biomarkers were strongly predictive of mortality and VTE. This might help identify biomarkers to risk stratify for clinical interventions in addition to the clinical picture.