Sat Aug 13 2022


Soluble Urokinase Plasminogen Activator Receptor and Venous Thromboembolism in COVID‐19


Higher suPAR was associated with incident venous thromboembolism (VTE) independently of D‐dimer in patients hospitalized for COVID‐19. Combining suPAR and D‐dimer identified patients at low VTE risk.


Venous thromboembolism (VTE) contributes significantly to COVID‐19 morbidity and mortality. The urokinase receptor system is involved in the regulation of coagulation. Levels of soluble urokinase plasminogen activator receptor (suPAR) reflect hyperinflammation and are strongly predictive of outcomes in COVID‐19. Whether suPAR levels identify patients with COVID‐19 at risk for VTE is unclear.

Methods and Results

We leveraged a multinational observational study of patients hospitalized for COVID‐19 with suPAR and D‐dimer levels measured on admission. In 1960 patients (mean age, 58 years; 57% men; 20% Black race), we assessed the association between suPAR and incident venous thromboembolism (VTE) (defined as pulmonary embolism or deep vein thrombosis) using logistic regression and Fine‐Gray modeling, accounting for the competing risk of death. VTE occurred in 163 (8%) patients and was associated with higher suPAR and D‐dimer levels. There was a positive association between suPAR and D‐dimer (β=7.34; P=0.002). Adjusted for clinical covariables, including D‐dimer, the odds of VTE were 168% higher comparing the third with first suPAR tertiles (adjusted odds ratio, 2.68 [95% CI, 1.51–4.75]; P<0.001). Findings were consistent when stratified by D‐dimer levels and in survival analysis accounting for death as a competing risk. On the basis of predicted probabilities from random forest, a decision tree found the combined D‐dimer <1 mg/L and suPAR <11 ng/mL cutoffs, identifying 41% of patients with only 3.6% VTE probability.


published suPAR studies in leading medical journals

Nature Medicine Logo
Science Journal Logo
JAMA Pediatrics Logo

The suPARnostic® brand consists of 4 products:

Quick Triage

A Point of Care Solution


For Automated Systems


Clinical and Research

suPARnostic POC+


Point-of-care finger prick

New Webinar


Catch COVID-19

-Improve your triage

Sign up to view webinar recording

View recording

suPARnostic® by ViroGates