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Vol 8, No 4 (2023)
Research paper
Published online: 2023-09-14
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Breaking down the clotting conundrum: analyzing the role of plasma tissue plasminogen activator in COVID-19 patients through a systematic review and meta-analysis

Kacper Dziedzic1, Mansur Rahnama-Hezavah2, Monika Tomaszewska1, Agnieszka Szarpak3, Aleksandra Gasecka4, Krzysztof Kuleta4, Oliwia Fidali4, Michal Pruc56, Aleksander Ostenda7, Magdalena Wierzbnik-Stronska7, Aldona Kubica8, Francesco Chirico9
DOI: 10.5603/demj.97097
·
Disaster Emerg Med J 2023;8(4):207-215.
Affiliations
  1. Department of Clinical Research and Development, LUX MED Group, Warsaw, Poland
  2. Chair and Department of Oral Surgery, Medical University of Lublin, Poland
  3. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  4. 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
  5. Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
  6. Department of Public Health, International Academy of Ecology and Medicine, Kyiv, Ukraine
  7. Faculty of Medicine, Academy of Silesia, Katowice, Poland
  8. Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
  9. Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy

open access

Vol 8, No 4 (2023)
ORIGINAL ARTICLES
Published online: 2023-09-14

Abstract

INTRODUCTION: The SARS-CoV-2 virus pandemic has been a global challenge for medical services in terms of patient care and early prognosis of hospitalized patients' situations. Early identification and classification of COVID-19 patients in hospitals is critical for optimal management. The purpose of this study is to compile existing data on tissue plasminogen activator (tPA) concentrations in COVID-19 patients.

MATERIAL AND METHODS: A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Qualified articles were found systematically using relevant databases such as PubMed Central, Scopus, EMBASE, and the Cochrane databases until May 4th, 2023.

RESULTS: Tissue plasminogen activator levels among COVID-19 positive vs negative patients T-PA levels among COVID-19 positive vs negative patients varied and amounted to 26.67 ± 40.65 vs 4.68 ± 3.83, respectively (SMD = 2.49; 95% CI: 1.85 to 3.14; p < 0.001). The mean t-PA level among patients requiring ICU admission was 24.06 ± 12.44, compared to 16.55 ± 10.01 for patients not treated in the ICU (SMD = 0.69; 95% CI: −0.68 to 2.05; p = 0.32). Moreover, t-PA levels among severe COVID-19 compared to non-severe were 11.89 ± 9.05 and 16.87 ± 20.39, respectively (SMD = 2.74; 95% CI: −0.71 to 6.19; p = 0.12). The t-PA values were, respectively: 15.33 ± 8.01 for patients who survived hospital discharge, and 19.04 ± 11.88 for patients who died in hospital due to COVID-19 (SMD = −0.50; 95% CI: −2.45 to 1.44; p = 0.61).

CONCLUSIONS: According to this meta-analysis, the key conclusion of this study is that COVID-19 infection is connected to t-PA levels. Nonetheless, extensive prospective studies addressing the possible diagnostic relevance of t-PA as a marker of COVID-19 severity are required to corroborate the presented results.

Abstract

INTRODUCTION: The SARS-CoV-2 virus pandemic has been a global challenge for medical services in terms of patient care and early prognosis of hospitalized patients' situations. Early identification and classification of COVID-19 patients in hospitals is critical for optimal management. The purpose of this study is to compile existing data on tissue plasminogen activator (tPA) concentrations in COVID-19 patients.

MATERIAL AND METHODS: A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Qualified articles were found systematically using relevant databases such as PubMed Central, Scopus, EMBASE, and the Cochrane databases until May 4th, 2023.

RESULTS: Tissue plasminogen activator levels among COVID-19 positive vs negative patients T-PA levels among COVID-19 positive vs negative patients varied and amounted to 26.67 ± 40.65 vs 4.68 ± 3.83, respectively (SMD = 2.49; 95% CI: 1.85 to 3.14; p < 0.001). The mean t-PA level among patients requiring ICU admission was 24.06 ± 12.44, compared to 16.55 ± 10.01 for patients not treated in the ICU (SMD = 0.69; 95% CI: −0.68 to 2.05; p = 0.32). Moreover, t-PA levels among severe COVID-19 compared to non-severe were 11.89 ± 9.05 and 16.87 ± 20.39, respectively (SMD = 2.74; 95% CI: −0.71 to 6.19; p = 0.12). The t-PA values were, respectively: 15.33 ± 8.01 for patients who survived hospital discharge, and 19.04 ± 11.88 for patients who died in hospital due to COVID-19 (SMD = −0.50; 95% CI: −2.45 to 1.44; p = 0.61).

CONCLUSIONS: According to this meta-analysis, the key conclusion of this study is that COVID-19 infection is connected to t-PA levels. Nonetheless, extensive prospective studies addressing the possible diagnostic relevance of t-PA as a marker of COVID-19 severity are required to corroborate the presented results.

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Keywords

tissue plasminogen activator; t-PA; COVID-19; SARS-CoV-2; coagulopathy

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Title

Breaking down the clotting conundrum: analyzing the role of plasma tissue plasminogen activator in COVID-19 patients through a systematic review and meta-analysis

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 8, No 4 (2023)

Article type

Research paper

Pages

207-215

Published online

2023-09-14

Page views

463

Article views/downloads

215

DOI

10.5603/demj.97097

Bibliographic record

Disaster Emerg Med J 2023;8(4):207-215.

Keywords

tissue plasminogen activator
t-PA
COVID-19
SARS-CoV-2
coagulopathy

Authors

Kacper Dziedzic
Mansur Rahnama-Hezavah
Monika Tomaszewska
Agnieszka Szarpak
Aleksandra Gasecka
Krzysztof Kuleta
Oliwia Fidali
Michal Pruc
Aleksander Ostenda
Magdalena Wierzbnik-Stronska
Aldona Kubica
Francesco Chirico

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