Evidence map›Paper›PMID 40106444›Full record

ArticlePloS one2025

Enhanced prediction of thrombotic events in hospitalized COVID-19 patients with soluble thrombomodulin.

Sergio Padilla, María Andreo, Pascual Marco, Ana Marco-Rico, Christian Ledesma, Marta Fernández-González, Javier García-Abellán, Paula Mascarell, Ángela Botella, Félix Gutiérrez and 1 more

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sergio PadillaInfectious Diseases Unit and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.ORCID https://orcid.org/0000-0002-8420-7310
María AndreoInternal Medicine Service and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.
Pascual MarcoHematology Department, Hospital General Universitario Dr. Balmis, Alicante, Spain.
Ana Marco-RicoHematology Department, Hospital General Universitario Dr. Balmis, Alicante, Spain.
Christian LedesmaInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain.
Marta Fernández-GonzálezCIBER de Enfermedades Infecciosas (CIBERINFEC; Biomedical Research Networking Center for Infectious Diseases), Instituto de Salud Carlos III, Madrid, Spain.
Javier García-AbellánInfectious Diseases Unit and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.
Paula MascarellInfectious Diseases Unit and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.
Ángela BotellaInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain.
Félix GutiérrezInfectious Diseases Unit and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.
Mar MasiáInfectious Diseases Unit and Department of Clinical Medicine, Hospital General Universitario and Universidad Miguel Hernández de Elche, Alicante, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We aimed to determine the predictive accuracy of elevated soluble thrombomodulin (sTM) and angiopoietin-2 (Ang2) for thrombotic events (TE) in hospitalized COVID-19 patients. We conducted a nested case-control study within a cohort of people admitted to hospital with COVID-19 from March 2020 to August 2022. The cases (people with TE within 28 days after hospital admission) were matched by propensity score to comparable patients without TE. We determined plasma levels of sTM and Ang2 in all available frozen samples, prioritizing the earliest post-admission samples, using an automated immunoassay technique. Among 2,524 hospitalized COVID-19 patients (43% females; median age 67 years), 73 had TE (incidence 1.15 events per 1000 patient-days of follow-up). Frozen plasma samples were available for 43 cases and 176 controls. Elevated plasma concentration of sTM was significantly associated with TE (2.8 [1.8, 4] vs. 1.52 [1.1, 2.65] ng/mL; p =  0.001) and mortality (median [Q1, Q3], 3.32 [2.16, 4.65] vs. 1.58 [1.11, 2.73] ng/mL; p =  0.001), while D-dimer showed a specific association with TE (2.3 [0.8, 7.4] vs. 0.75 [0.4, 1.6] mcg/mL; p =  0.001). In contrast, Ang2 was not associated with any of these events. The association with thrombotic events remained in adjusted models (HR [95%CI] per unit increase, 1.24 [1.04-1.47] for sTM; 1.07 [1.03-1.10] for D-dimer). The adjusted regression model that included both biomarkers, sTM and D-dimer, improved (AUC 73%, sensitivity 77% and specificity 65% for TE diagnosis; p =  0.007) the predictive capacity of the same model without sTM. In conclusion, determination of soluble thrombomodulin along with D-dimer enhances thrombotic risk assessment in hospitalized COVID-19 patients.

Indexed as

COVID-19ThrombomodulinThrombosisAgedAged, 80 and overAngiopoietin-2BiomarkersCase-Control StudiesFemaleFibrin Fibrinogen Degradation ProductsHospitalizationHumansMaleMiddle AgedSARS-CoV-2Angiopoietin-2ANGPT2 protein, humanBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DTHBD protein, humanThrombomodulin

Identifiers

PMID40106444
PMCPMC11922281

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.