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    Oral Communication

    COVID

    Risk Factors and Treatment in COVID-19

    OC 05.5 - Hemostatic biomarkers in Long-Covid syndrome: A cross-sectional study of 1,310 Covid-19 survivors

    Saturday, June 24, 2023
    14:00 – 14:15 ET
    Room: 511
    Session Available As: On-Demand

      Co-Author(s)

    • CA

      Chiara Ambaglio

      MD
      Department of Immunohematology and Transfusion Medicine, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • SB

      Simone Vasiij Benatti

      MD
      Division of Infectious Diseases, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • CT

      Carmen Julia Tartari

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • CG

      Cinzia Giaccherini

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • LR

      Laura Russo

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • SG

      Sara Gamba

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • SB

      Silvia Bolognini

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • CT

      Chiara Ticozzi

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • CV

      Cristina Verzeroli

      Researcher
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • FS

      Francesca Schieppati

      MD
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • VB

      Varusca Brusegan

      MD
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • SV

      Serena Venturelli

      MD
      Division of Infectious Diseases, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • LB

      Luca Barcella

      MD
      Department of Immunohematology and Transfusion Medicine, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • MR

      Marco Rizzi

      MD
      Division of Infectious Diseases, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    • Marina Marchetti, PhD (she/her/hers)

      Hemostasis Lab Director
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

      • Presenting Author(s)

    • Anna Falanga, MD (she/her/hers)

      Professor of Hematology
      Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
      Bergamo, Lombardia, Italy

    Background: The term ‘long-Covid’ is used to describe in Covid-19 survivors the persistence of symptoms beyond 4 weeks and includes ‘ongoing symptomatic’ (4-12 weeks) and ‘post-Covid-19’ syndrome (>12 weeks) phases, based on symptoms’ duration.

    Aims: To evaluate the possible role of hemostasis alterations for the diagnosis of the long-Covid syndrome in a large cohort of Covid-19 survivors.

    Methods: A clinical and diagnostic multidisciplinary follow-up of Covid-19 patients discharged from our Institution after the first pandemic wave was implemented (ACCORDI Study, July – November 2020). In 1310 out of 1471 Covid-19 survivors who attended the clinical visit, blood samples were obtained for measurements of blood cell count, liver and renal function tests, LDH, C-reactive protein, fibrinogen, prothrombin fragment 1+2, D-dimer, von Willebrand factor antigen, thrombomodulin (TM), tissue plasminogen activator and its inhibitor PAI-1.

    Results: In the 1310 survivor cohort (863M/447F, median age 60 years, median time from Covid-19 onset=127 days), clinical symptoms were: cardiopulmonary in 44% of subjects, flu-like in 31%, respiratory in 22%, and neurological in 6%. The long-Covid syndrome was diagnosed in 655 patients (375M/280F): 95 classified as ‘ongoing symptomatic’ and 560 as ‘post-Covid’. The hemostatic laboratory analysis showed no significant differences in the biomarkers’ levels between long-COVID and symptom-free survivors. However, among subjects assessed within 12 weeks from disease onset, the ‘ongoing symptomatic’ group showed significantly higher TM levels (p < 0.05) compared with the symptom-free group. Further, after logistic regression analysis corrected for age and gender, TM or PAI-1 levels above the 75th percentile were found significantly associated with a diagnosis of long-Covid (OR 2.156; 95% CI:1.24-3.75; p=0.007).

    Conclusion(s): Our study shows the occurrence of endothelial perturbance in ongoing symptomatic long-Covid patients and identifies two endothelial activation biomarkers (i.e., TM and PAI-1) potentially helpful to identify this new long-Covid syndrome.

    Learning Objectives:

    • Upon completion, participants will be able to: - Recognize the characteristics of the ‘Long-Covid syndrome’
    • Upon completion, participants will be able to: - Identify the contribution of hemostatic biomarkers to the definition of this syndrome
    • Upon completion, participants will be able to: - Evaluate the role of previous history of thrombotic events in the occurrence of the long-Covid syndrome