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    COVID-19 disease progression can be accompanied by a "cytokine storm" that leads to secondary sequelae such as acute respiratory distress syndrome. Several inflammatory cytokines have been associated with COVID-19 disease progression, but have high daily intra-individual variability. In contrast, we have shown that the inflammatory biomarker γ' fibrinogen (GPF) has a 6-fold lower coefficient of variability compared to other inflammatory markers such as hs-CRP. The aims of the study were to measure GPF in serial blood samples from COVID-19 patients at a tertiary care medical center in order to investigate its association with clinical measures of disease progression. COVID-19 patients were retrospectively enrolled between 3/16/2020 and 8/1/2020. GPF was measured using a commercial ELISA. We found that COVID-19 patients can develop extraordinarily high levels of GPF. Our results showed that ten out of the eighteen patients with COVID-19 had the highest levels of GPF ever recorded. The previous highest GPF level of 80.3 mg/dL was found in a study of 10,601 participants in the ARIC study. GPF levels were significantly associated with the need for ECMO and mortality. These findings have potential implications regarding prophylactic anticoagulation of COVID-19 patients. Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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    Matthew Hudkins, Heather Hamilton, Samantha J Underwood, Diana E Kazmierczak, Elizabeth N Dewey, Steven C Kazmierczak, William B Messer, Akram Khan, Martin A Schreiber, David H Farrell. Extreme γ' fibrinogen levels in COVID-19 patients. Blood cells, molecules & diseases. 2024 Jul;107:102856

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    PMID: 38762921

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