The ADAMTS13-von Willebrand factor axis in COVID-19 patients.
J Thromb Haemost
; 19(2): 513-521, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-991626
ABSTRACT
BACKGROUND:
Severe coronavirus disease 2019 (COVID-19) is characterized by an increased risk of thromboembolic events, with evidence of microthrombosis in the lungs of deceased patients.OBJECTIVES:
To investigate the mechanism of microthrombosis in COVID-19 progression. PATIENTS/METHODS:
We assessed von Willebrand factor (VWF) antigen (VWFAg), VWF ristocetin-cofactor (VWFRCo), VWF multimers, VWF propeptide (VWFpp), and ADAMTS13 activity in a cross-sectional study of 50 patients stratified according to their admission to three different intensity of care units low (requiring high-flow nasal cannula oxygenation, n = 14), intermediate (requiring continuous positive airway pressure devices, n = 17), and high (requiring mechanical ventilation, n = 19).RESULTS:
Median VWFAg, VWFRCo, and VWFpp levels were markedly elevated in COVID-19 patients and increased with intensity of care, with VWFAg being 268, 386, and 476 IU/dL; VWFRCo 216, 334, and 388 IU/dL; and VWFpp 156, 172, and 192 IU/dL in patients at low, intermediate, and high intensity of care, respectively. Conversely, the high-to-low molecular-weight VWF multimers ratios progressively decreased with increasing intensity of care, as well as median ADAMTS13 activity levels, which ranged from 82 IU/dL for patients at low intensity of care to 62 and 55 IU/dL for those at intermediate and high intensity of care.CONCLUSIONS:
We found a significant alteration of the VWF-ADAMTS13 axis in COVID-19 patients, with an elevated VWFAg to ADAMTS13 activity ratio that was strongly associated with disease severity. Such an imbalance enhances the hypercoagulable state of COVID-19 patients and their risk of microthrombosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Thrombosis
/
Blood Coagulation
/
Von Willebrand Factor
/
ADAMTS13 Protein
/
COVID-19
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Thromb Haemost
Journal subject:
Hematology
Year:
2021
Document Type:
Article
Affiliation country:
Jth.15191
Similar
MEDLINE
...
LILACS
LIS