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1164 Gamma' Fibrinogen Levels As a Biomarker of COVID-19 Severity

Program: Oral and Poster Abstracts
Session: 322. Disorders of Coagulation or Fibrinolysis: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, adult, epidemiology, Clinical Research, Diseases, SARS-CoV-2/COVID-19, Infectious Diseases, Study Population, Human
Saturday, December 10, 2022, 5:30 PM-7:30 PM

Lucy Z Kornblith1*, Bindhya Sadhanandhan2*, Sreepriya Arun2*, Rebecca Long3*, Alicia J Johnson4*, Jamie Noll5*, CN Ramchand6*, John K Olynyk3* and David H Farrell, PhD7*

1University of California, San Francisco, San Francisco, CA
2Theragen Biologics Pvt Ltd, Chennai, India
3Edith Cowan University, Joondalup, Western Australia, Australia
4Oregon Health & Science University, Portland, OR
5Jamie Noll, Pharm.D. LLC, The Villages, FL
6MagGenome Pvt Ltd, Chennai, India
7Department of Surgery, Oregon Health & Science University, Portland, OR

Introduction: COVID-19 is associated with maladaptive inflammation that can lead to acute respiratory distress syndrome. We therefore investigated a novel inflammatory marker, γ' fibrinogen, which is associated with cardiovascular diseases.

Hypothesis: We had previously discovered that COVID-19 patients have among the highest levels of γ' fibrinogen that have ever been reported. We therefore hypothesized that γ' fibrinogen levels would be associated with disease severity.

Methods: 103 patients with COVID-19 and 19 healthy control volunteers were identified by RT-PCR. We measured γ' fibrinogen in blood draws from the patients and the controls. SpO2 levels were measured in patients at the time of the blood draw.

Results: We found significant associations between γ' fibrinogen levels and the severity of COVID-19. The mean level of γ' fibrinogen in the patients with COVID-19 was 69.8 mg/dL compared to 36.9 mg/dL in the controls, whereas C-reactive protein (CRP), lactate dehydrogenase (LDH), and total fibrinogen levels were not significantly different between groups. Using ROC curves, γ' fibrinogen differentiated between COVID-19 patients and controls very well (AUC 0.91, 95% CI: 0.85-0.98; Youden's index cutpoint 46.9 mg/dL, sensitivity 0.81, specificity 0.84), and all other biomarkers had lower AUC. In addition, γ' fibrinogen was significantly higher in patients with severe COVID-19 (SpO2<=93%), compared to mild/moderate COVID-19 (SpO2 >93%) (p = 0.012, AUC of 0.68, 95% CI 0.57-0.79; Youden's index cutpoint 65.2 mg/dL, sensitivity 0.63, specificity 0.70). In contrast, CRP, interleukin-6 (IL-6), ferritin, LDH, D-dimer, and total fibrinogen had weaker associations with COVID-19 disease severity (all ROC curves with lower AUCs). Furthermore, γ' fibrinogen levels did not correlate significantly with IL-6, ferritin, D-dimer, or total fibrinogen. These findings suggest that the associations between COVID-19 and COVID-19 severity with γ' fibrinogen levels cannot be due simply to total fibrinogen levels.

Conclusions: Our results suggest that γ' fibrinogen is a robust inflammatory marker for COVID-19 that may be useful in predicting COVID-19 disease severity.

Disclosures: Kornblith: Gamma Diagnostics, Inc.: Consultancy. Noll: Gamma Diagnostics, Inc.: Ended employment in the past 24 months. Farrell: Gamma Diagnostics, Inc.: Consultancy, Current equity holder in private company, Other: Founder, Research Funding.

*signifies non-member of ASH