Curative anticoagulation prevents endothelial lesion in COVID‐19 patients

Background Coronavirus disease‐2019 (COVID‐19) has been associated with cardiovascular complications and coagulation disorders. Objectives To explore the coagulopathy and endothelial dysfunction in COVID‐19 patients. Methods The study analyzed clinical and biological profiles of patients with suspected COVID‐19 infection at admission, including hemostasis tests and quantification of circulating endothelial cells (CECs). Results Among 96 consecutive COVID‐19‐suspected patients fulfilling criteria for hospitalization, 66 were tested positive for SARS‐CoV‐2. COVID‐19‐positive patients were more likely to present with fever (P = .02), cough (P = .03), and pneumonia at computed tomography (CT) scan (P = .002) at admission. Prevalence of D‐dimer >500 ng/mL was higher in COVID‐19‐positive patients (74.2% versus 43.3%; P = .007). No sign of disseminated intravascular coagulation were identified. Adding D‐dimers >500 ng/mL to gender and pneumonia at CT scan in receiver operating characteristic curve analysis significantly increased area under the curve for COVID‐19 diagnosis. COVID‐19‐positive patients had significantly more CECs at admission (P = .008) than COVID‐19‐negative ones. COVID‐19‐positive patients treated with curative anticoagulant prior to admission had fewer CECs (P = .02) than those without. Interestingly, patients treated with curative anticoagulation and angiotensin‐converting‐enzyme inhibitors or angiotensin receptor blockers had even fewer CECs (P = .007). Conclusion Curative anticoagulation could prevent COVID‐19‐associated coagulopathy and endothelial lesion.