Von Willebrand factor collagen-binding capacity predicts in-hospital mortality in COVID-19 patients: insight from VWF/ADAMTS13 ratio imbalance.
Angiogenesis
; 24(3): 407-411, 2021 08.
Article
in English
| MEDLINE | ID: covidwho-1222775
ABSTRACT
BACKGROUND:
Microthrombosis is a hallmark of COVID-19. We previously described von willebrand factor (VWF) and their high molecular weight multimers (HMWMs) as potential trigger of microthrombosis.OBJECTIVES:
Investigate VWF activity with collagen-binding assay and ADAMTS13 in COVID-19. METHODS ANDRESULTS:
Our study enrolled 77 hospitalized COVID-19 patients including 37 suffering from a non-critical form and 40 with critical form. Plasma levels of VWF collagen-binding ability (VWFCB) and ADAMTS13 activity (ADAMTS13Act) were measured in the first 48 hours following admission. VWFCB was increased in critical (631% IQR [460-704]) patients compared to non-critical patients (259% [235-330], p < 0.005). VWFCB was significantly associated (r = 0.564, p < 0.001) with HMWMs. Moreover, median ADAMTS13Act was lower in critical (64.8 IU/dL IQR 50.0-77.7) than non-critical patients (85.0 IU/dL IQR 75.8-94.7, p < 0.001), even if no patients displayed majors deficits. VWFAg-to-ADAMTS13Act ratio was highly associated with VWFCB (r = 0.916, p < 0.001). Moreover, VWFCB level was highly predictive of COVID-19 in-hospital mortality as shown by the ROC curve analysis (AUC = 0.92, p < 0.0001) in which we identified a VWFCB cut-off of 446% as providing the best predictor sensitivity-specificity balance. We confirmed this cut-off thanks to a Kaplan-Meier estimator analysis (log-rank p < 0.001) and a Cox-proportional Hazard model (HR = 49.1, 95% CI 1.81-1328.2, p = 0.021) adjusted on, BMI, C-reactive protein, and D-dimer levels.CONCLUSION:
VWFCB levels could summarize both VWF increased levels and hyper-reactivity subsequent to ADAMTS13 overflow and, therefore, be a valuable and easy to perform clinical biomarker of microthrombosis and COVID-19 severity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Von Willebrand Factor
/
Pandemics
/
ADAMTS13 Protein
/
SARS-CoV-2
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
Angiogenesis
Journal subject:
Hematology
Year:
2021
Document Type:
Article
Affiliation country:
S10456-021-09789-3
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