Thrombotic complications of COVID-19 and its relation with NADPH oxidase and tissue factor

Background: The severe acute respiratory syndrome corona-virus 2 (SARS CoV-2) is the virus responsible for the corona-virus disease 19 (COVID-19), a highly contagious and pathogenic viral illness. Individuals with severe illnesses may develop acute respiratory distress syndrome (ARDS) and have altered coagulation functioning, which puts them at risk for developing thromboembolic consequences. This work aimed to evaluate the relation between NADPH oxidase 2 (NOX2), tissue factor (TF) and the thrombotic complications in COVID-19 infection. Subjects: This case-control work was performed on 180 subjects. Individuals with COVID-19 group included 100 patients proved to be COVID-19 positive. Control group included 80 apparently healthy age and sex matched subjects.Methods: Blood levels of NOX2, TF and Interleukin-6 (IL-6) had been assessed by sandwich enzyme-linked immune-sorbent assay (ELISA) method.Results: a substantial increase was existed in NOX2, TF and IL-6 in COVID-19 patients and patients with thromboembolic events (TEEs) when compared with control subjects and patients without TEEs. ROC curve for serum NOX2 to predict thromboembolic events showed sensitivity 96.55, specificity 94.37 and positive predictive value 87.5. ROC curve for plasma TF to predict thromboembolic events had sensitivity 93.10, specificity 92.96, and positive predictive value 84.4.Conclusions: High levels of NADPH oxidase2, tissue factor and IL-6 are associated with increased incidences of the thromboembolic complications, mortality rates and admission at ICU in individuals with COVID-19.