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The Prognostic Value of ADAMTS-13 and von Willebrand Factor in COVID-19 Patients: Prospective Evaluation by Care Setting.
Tiscia, Giovanni; Favuzzi, Giovanni; De Laurenzo, Antonio; Cappucci, Filomena; Fischetti, Lucia; Colaizzo, Donatella; Chinni, Elena; Florio, Lucia; Miscio, Giuseppe; Piscitelli, Angela Pamela; Mastroianno, Mario; Grandone, Elvira.
  • Tiscia G; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Favuzzi G; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • De Laurenzo A; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Cappucci F; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Fischetti L; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Colaizzo D; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Chinni E; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Florio L; Unit of Neurology, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Miscio G; Unit of Transfusion Medicine and Clinical Pathology, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Piscitelli AP; Unit of Internal Medicine, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Mastroianno M; Scientific Direction, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
  • Grandone E; Thrombosis and Haemostasis Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
Diagnostics (Basel) ; 11(9)2021 Sep 09.
Article in English | MEDLINE | ID: covidwho-1408835
ABSTRACT

BACKGROUND:

Endothelial dysfunction, coupled with inflammation, induces thrombo-inflammation. In COVID-19, this process is believed to be associated with clinical severity. Von Willebrand factor (VWF), and a disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS-13), are strong markers of endothelial dysfunction. We evaluated the impact of the VWF/ADAMTS-13 fraction on COVID-19 severity and prognosis. MATERIALS AND

METHODS:

A cohort study including 74 COVID-19 patients, with 22 admitted to the intensive care unit (ICU) and 52 to the medical ward (MW), was carried out. We also evaluated, in a group of 54 patients who were prospectively observed, whether variations in VWF/ADAMTS-13 correlated with the degree of severity and routine blood parameters.

RESULTS:

A VWFRCo/ADAMTS-13 fraction above 6.5 predicted in-hospital mortality in the entire cohort. At admission, a VWFRCo/ADAMTS-13 fraction above 5.7 predicted admission to the ICU. Furthermore, the VWFRCo/ADAMTS-13 fraction directly correlated with C-reactive protein (CRP) (Spearman r 0.51, p < 0.0001) and D-dimer (Spearman r 0.26, p = 0.03). In the prospective cohort, dynamic changes in VWFRCo/ADAMTS-13 and the CRP concentration were directly correlated (Spearman r, p = 0.0014). This relationship was significant in both groups (ICU p = 0.006; MW p = 0.02).

CONCLUSIONS:

The present findings show that in COVID-19, the VWF/ADAMTS-13 fraction predicts in-hospital mortality. The VWF/ADAMTS-13 fraction may be a helpful tool to monitor COVID-19 patients throughout hospitalization.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Diagnostics11091648

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Year: 2021 Document Type: Article Affiliation country: Diagnostics11091648