ADAMTS13 in the diagnosis of the severity of COVID-19 mortality

ABSTRACT

Background: Patients with severe respiratory failure come to the hospital emergency room, where they are triaged to support lung ventilation. Coagulation markers are one of the important methods for triage. The main method used so far is DDIM. Their elevation is due to the activation of coagulation with prothrombogenic potential, which manifests itself mainly in the microcirculation. These processes lead to the excessive release of Von Willebrand factor (VWF) from the Weibel Palade bodies and its cleavage by ADAMTS13, which is thus consumed. Aim(s) The aim of our study was to assess the effect of ADAMTS13 levels on the prognosis of patients with acute respiratory failure due to COVID-19 infection. Method(s) 46 patients coming to the emergency department were examined and admitted to the intensive care unit to support lung function based on clinical symptoms and elevated D-Dimers. These patients were retrospectively examined for ADAMTS13. Result(s) The levels of ADAMTS13 showed a statistically significant difference (P = 0.02) that corresponded to the clinical course of severe respiratory failure due to COVID-19 infection. Ninghteen patients with a relatively mild course had an ADAMTS13 level of 0.74 IU/ml (0.28 -1.14 IU/ml), in contrast to a skip of 27 patients with a severe course, which had an ADAMTS13 level of 0.54 IU/ml (0.25 -1.01 IU/ml). Conclusion(s) The levels of D-Dimer as a commonly used marker in triage of the COVID-19 severity infection is mainly due to the activation of coagulation and its manifestations, especially in the microcirculation. The level of ADAMTS13 is a key marker in the early prognosis of the severity of COVID-19 due to pulmonary insufficiency, whereas D-DIm is only a consequence of this process.