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Over time relationship between platelet reactivity, myocardial injury and mortality in patients with SARS-CoV-2-associated respiratory failure

机译：SARS-COV-2相关呼吸衰竭患者血小板反应性，心肌损伤和死亡率之间的时间关系

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摘要

The aim of this study (NCT04343053) is to investigate the relationship between platelet activation, myocardial injury, and mortality in patients affected by Coronavirus disease 2019 (COVID-19). Fifty-four patients with respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were enrolled as cases. Eleven patients with the same clinical presentation, but negative for SARS-CoV-2 infection, were included as controls. Blood samples were collected at three different time points (inclusion [T1], after 7 +/- 2 days [T2] and 14 +/- 2 days [T3]). Platelet aggregation by light transmittance aggregometry and the circulating levels of soluble CD40 ligand (sCD40L) and P-selectin were measured. Platelet biomarkers did not differ between cases and controls, except for sCD40L which was higher in COVID-19 patients (p = .003). In COVID-19 patients, P-selectin and sCD40L levels decreased from T1 to T3 and were higher in cases requiring admission to intensive care unit (p = .004 and p = .008, respectively). Patients with myocardial injury (37%), as well as those who died (30%), had higher values of all biomarkers of platelet activation (p < .05 for all). Myocardial injury was an independent predictor of mortality. In COVID-19 patients admitted to hospital for respiratory failure, heightened platelet activation is associated with severity of illness, myocardial injury, and mortality.
机译：本研究（NCT04343053）的目的是研究2019年冠状病毒病（COVID-19）患者血小板活化、心肌损伤和死亡率之间的关系。54例因严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染而导致呼吸衰竭的患者被纳入病例。11名临床表现相同但SARS-CoV-2感染阴性的患者作为对照。在三个不同的时间点（包括[T1]、7+/-2天后[T2]和14+/-2天后[T3]）采集血样。通过透光率聚集法测定血小板聚集，并测定可溶性CD40配体（sCD40L）和P-选择素的循环水平。血小板生物标志物在病例组和对照组之间没有差异，除了SCD40L在COVID-19患者中更高（P＝003）。COVID2019冠状病毒疾病患者P-选择素和sCD40L水平从T1下降到T3，在ICU住院患者中的比例较高（P＝004，P＝008）。心肌损伤患者（37%）和死亡患者（30%）的血小板活化的所有生物标志物值均较高（均p<0.05）。心肌损伤是死亡率的独立预测因素。2019冠状病毒疾病患者入院呼吸衰竭时，血小板活化程度升高与病情严重程度、心肌损伤和死亡率有关。

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