Yanhong Liu,1 Bo Guo,2 Zhen Meng,1 Yanru Fan,1 Yan Xie,1 Lan Gao,1 Rufei Ma1 

1Department of Laboratory Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, Henan, People’s Republic of China; 2Department of Critical Care Medicine, Henan Key Laboratory for Critical Care Medicine, Zhengzhou Key Laboratory for Critical Care Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, Henan, People’s Republic of China

Correspondence: Lan Gao, Department of Laboratory Medicine, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou, Henan, 450003, People’s Republic of China, Email gaolan@zzu.edu.cn Rufei Ma, Department of Laboratory Medicine, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou, Henan, 450003, People’s Republic of China, Email 1036316672@qq.com

Background: Venous thromboembolism (VTE) is associated with high morbidity and mortality. In recent years, increasing evidence has suggested that inflammation plays a critical role in the pathogenesis of VTE. Patients with pneumonia often exhibit an inflammatory response. This study aimed to investigate the correlation between inflammatory indicators and VTE by analyzing laboratory indicators in patients with pneumonia and VTE.
Methods: Samples were collected from patients with pneumonia admitted between December 2022 and March 2023. Patients were classified into the VTE and non-VTE groups according to whether they had VTE or not. Propensity score matching (PSM) was performed to control for potential confounding factors. Coagulation and inflammatory indicators were measured. Statistical analyses were performed to identify biomarkers that exhibited significant differences between the two groups, and the relationship between coagulation and inflammatory indicators was further explored.
Results: D-dimer, thrombin-antithrombin complex (TAT), plasmin‐α 2‐antiplasmin complex (PIC), t‐PA:PAI‐1 complex (tPAIC), and thrombomodulin (TM) levels were significantly higher in the VTE group. White blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), and C-reactive protein (CRP) levels were significantly elevated in VTE group. The areas under the curve (AUC) of the receiver operator characteristic (ROC) curves for D-dimer, TAT, PIC, tPAIC, and TM were 0.806, 0.691, 0.656, 0.621, and 0.641, respectively, while the areas for WBC, NLR, CRP, and PCT were 0.690, 0.647, 0.618, and 0.651, respectively. Correlation analysis revealed that WBC was significantly correlated with D-dimer, TAT, PIC and TM. NLR was correlated with D-dimer and TM. CRP was correlated with D-dimer and TM.
Conclusion: There is a significant activation of both coagulation and fibrinolytic systems in pneumonia patients. VTE in pneumonia patients is associated with the activation of inflammatory system. Monitoring inflammatory and coagulation indicators in pneumonia patients can facilitate early identification of individuals at an elevated risk of VTE.

Keywords: pneumonia, coagulation, inflammation, indicators