Blood viscosity falls into the COVID mortality equation

Observational studies have shown that people with thick blood are less likely to survive hospitalization for COVID-19.

Estimated high-shear and low-shear blood viscosities (eHSBV and eLSBV) are associated with increased in-hospital mortality as estimates of whole blood viscosities at various shear velocities, with an increase of 1 unit of 36.0% and 7.0%, respectively. Was related to. Each has a high risk of death (P<0.001).

Even after adjusting for interleukin-6 and other inflammatory biomarkers, only high concentrations of measurements are significantly associated with mortality, says a cardiologist at Mount Sinai Medical Center in New York City. Robert Rosenson, MD and colleagues reported in the July 26 issue. Journal of American College of Cardiology..

The results of the study confirmed the association between hyperviscosity and immune thrombosis in acute COVID-19 disease.

“This study demonstrates the importance of checking blood viscosity in COVID-19 patients early in hospitalization. This is easy to obtain in routine laboratory work. The results are optimal for patients at risk. It helps you determine the right course of treatment and improve outcomes. ” Rosenson in the press release.

“We are currently investigating the effects of therapeutic heparin on reducing the risk of complications during acute COVID-19 infection, which can have significant benefits for people with hypertension,” he said. Added.

In a large platform trial, therapeutic doses of heparin improved survival in hospitalized COVID-19 patients Outside the ICU However Not in ICU.. However, these studies did not incorporate blood viscosity as a factor.

Rosenson’s observational study included 5,621 COVID-19 patients admitted to six hospitals in the Mount Sinai Health System.

The authors of the study noted that whole blood viscosity (WBV) is a validated measure of blood rheology and an established predictor of cardiovascular risk. WBV is primarily determined by hematocrit, plasma viscosity, erythrocyte aggregation, and erythrocyte deformability.

However, this study did not measure WBV directly, but instead relied on hematocrit levels, albumin, and an estimated BV (eBV) calculated from total protein levels per Walburn-Schneck model.

“It is of utmost importance to refine risk stratification strategies to identify subjects with COVID-19 who are at high risk of disease progression, especially following the introduction of new antiviral agents for COVID-19 administered in the community. Therefore, eBV in a larger population of COVID-19 outpatients is desirable. ” Chieti-Pescara, also in Italy.

“EBV requires proper validation, both externally and in the future, but has been shown to be an early and powerful predictor of mortality, making it a likely and widely used biomarker. It is possible and relatively inexpensive. The potential for translations related to eBV, further research to confirm and expand current findings to advance eBV into clinical scenarios is enthusiastically guaranteed. ” Ancillary editorial..

The COVID-19 patients included in this study were hospitalized at some point between early 2020 and late 2021.

Participants with high eHSBV tended to have high inflammatory markers at baseline. People with the highest quartile of eHSBV are likely to be men of black or Hispanic race or ethnicity, have a history of diabetes, and require oxygen support at the time of presentation.

Maximum eHSBV quartile (range 4.53-9.86 cm pores) [cP]) There was a significant excess mortality rate compared to the lowest quartiles in the 3.01 to 4.00 cP range (adjusted HR 1.53, 95% CI 1.27-1.84). Differences were consistent among subgroups, except for Asians who showed no difference in mortality between the highest and lowest quartiles.

“It has been reported that hyperviscosity may increase the risk of developing thrombotic events in critically ill patients with COVID-19, but a subsequent mechanism presumed to be the proposed mechanism (ie, hyperviscosity). There is a clear and direct link to clinical events (ie, thrombosis), which is still lacking. “

The authors of the study noted the limitations of the study in its retroactive nature and the lack of direct measurement of WBV. Late Pandemic Patients- New variant When vaccination -Also, it was not included in the study.

“The effects of different SARS-CoV-2 mutants and vaccines on blood viscosity have not yet been elucidated,” said Bonaventura and Potere.