ISTH Congress Abstracts

Official abstracts site for the ISTH Congress

MENU 
  • Home
  • Congress Archive
    • ISTH 2022 Congress
    • ISTH 2021 Congress
    • ISTH 2020 Congress
  • Resources
  • Search

Increased von Willebrand Factor (VWF) and Factor VIII (FVIII) Levels in Severe Acute Respiratory Syndrome Sars-Cov2-positive Pneumonia Compared with Severe Acute Respiratory Syndrome Sars-Cov2-negative: A Case-control Study

M. Sacco1, R. De Cristofaro2,1, G. Liuzzo3, S. Lancellotti2, D. Pedicino3, F. Andreotti3

1Catholic University School of Medicine, Translational Medicine and Surgery Department, Rome, Italy, 2Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Center for Hemorrhagic and Thrombotic Diseases and Haemophilia Center, Rome, Italy, 3Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Department of Cardiovascular Science, Rome, Italy

Abstract Number: PB0198

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: The SARS-COV-2 direct interaction with Angiotensin-Converting-Enzyme-2 (ACE2) membrane receptor on pulmonary epithelial and endothelial cells, impairs angiotensin 1-7 production and its vasculoprotective role, promoting an upregulation of the ACE/angiotensinII/angiotensinII receptor type-1 pathway. The consequent endothelial activation and increasing secretion of VWF and FVIII levels contributes to complement activation and leukocyte extravasation, leading to local microcirculation damage.

Aims: Our case-control study is aimed to investigate the characteristics of thrombotic microangiopathies (TMA)-like syndromes in COVID-19 evaluating VWF, FVIII and ADAMTS-13 levels, because the complement-mediated TMA and multiorgan microvascular lesions, observed in COVID-19 patients, seem not attributable to typical TMA.

Methods: Ten COVID-19 cases presenting fever, cough and sore throat, admitted to the Fondazione Policlinico Gemelli IRCCS, Rome, and diagnosed by RT-PCR, were compared to ten control patients with non-SARS-CoV-2 interstitial pneumonia, diagnosed by chest Xray/computerized tomography; notably no patient needed mechanical ventilation.
ADAMTS-13 activity was measured by a FRET-based assay; FVIII levels by a two-stage clotting assay, while VWF:antigen and VWF:activity were evaluated by chemiluminescence assays. Platelet count, schistocytes, D-dimer, C-reactive protein were centrally measured.

Results: COVID-19 pneumonia patients compared with controls showed a marked elevation of both VWF:Ag (median values: 324.1 Vs 139.5%, p<0.0001) and VWF:act levels (median values: 341.5 Vs 133%, p<0.001), as well as FVIII levels (median values: 202.5 Vs 123%, p<0.0001), consistent with the presence of a thrombophilic condition; without significant differences in ADAMTS-13 activity (median values: 69 Vs 76%, p=0.473). In both groups, D-dimer and C-reactive protein levels were elevated, but not statistically different, platelet counts were normal, and schistocytes, a typical TMAs hallmark, were not observed

Conclusions: The increased VWF/FVIII levels in COVID-19 pneumonia cases compared with non-COVID-19 controls cannot be fully explained by the inflammatory state alone and was likely caused by SARS-CoV-2-mediated downregulation of the ACE2 axis, resulting in damage to the local microcirculation and increased leukocyte extravasation.

To cite this abstract in AMA style:

Sacco M, De Cristofaro R, Liuzzo G, Lancellotti S, Pedicino D, Andreotti F. Increased von Willebrand Factor (VWF) and Factor VIII (FVIII) Levels in Severe Acute Respiratory Syndrome Sars-Cov2-positive Pneumonia Compared with Severe Acute Respiratory Syndrome Sars-Cov2-negative: A Case-control Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/increased-von-willebrand-factor-vwf-and-factor-viii-fviii-levels-in-severe-acute-respiratory-syndrome-sars-cov2-positive-pneumonia-compared-with-severe-acute-respiratory-syndrome-sars-cov2-negativ/. Accessed September 24, 2023.

« Back to ISTH 2021 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/increased-von-willebrand-factor-vwf-and-factor-viii-fviii-levels-in-severe-acute-respiratory-syndrome-sars-cov2-positive-pneumonia-compared-with-severe-acute-respiratory-syndrome-sars-cov2-negativ/

Simple Search

Supported By:

Takeda logo

ISTH 2022 Congress site

Visit the official web site for the ISTH 2022 Virtual Congress ยป

  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2023 John Wiley & Sons, Inc. All Rights Reserved.
Wiley