COVID-19 Hypercoagulability Association with Serum Levels of Homocysteine and SCUBE-1

Background: Hypercoagulable state is a major complication of the coronavirus disease-2019 (COVID-19), with a possible result of debility and/or mortality. Homocysteine and SCUBE-1 are plasma biomarkers; their abnormal levels are relatable to coagulation as a cause or an effect. Objectives: To investigate the association of homocysteine and SCUBE-1 with COVID-19–associated hypercoagulability. Materials and Methods: This is a cross-sectional study with ninety adult COVID-19 patients with variable severity. Patients were classified according to D-dimer level at the time of hospital admission into two groups: with and without hypercoagulability. Serum was extracted from centrifuged blood (collected in gel tubes) and stored at -20 ºC. Serum levels of homocysteine and SCUBE-1 were measured utilizing Chemiluminescense Immunoassay and Enzyme-Linked Immunosorbent Assay, respectively, using commercially available kits. Results: Thirty-eight patients (42.22%) out of the ninety had a hypercoagulable state, and the vast majority of patients with hypercoagulability (89.47%) had severe disease. The median (IQR) levels of homocysteine and SCUBE-1 in patients with hypercoagulability were 9.56 (8.75) µmol/L and 0.19 (0.11) ng/ml, respectively, which were higher than that of normal coagulable patients (8.15 [5.85] µmol/L and 0.16 [0.06] ng/ml, respectively) with highly significant differences (P-value = 0.044 and 0.01, respectively). Conclusion: Homocysteine and SCUBE-1 serum levels are significantly associated with COVID-19 hypercoagulability and disease severity, and may be utilized as adjunct biomarkers for prediction/diagnosis of hypercoagulability in COVID-19 patients.