Abstract Number: PB0166
Meeting: ISTH 2021 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: The coronavirus disease 2019 (COVID-19) increases thrombotic risk. The mechanisms that lead to this prothrombotic state are unclear.
Aims: The main aim was to evaluate the von Willebrand factor (VWF) antigen and plasma ADAMTS13 activity as endothelial injury markers in COVID-19 and their prognostic value in COVID-19 evolution.
Methods: We present a prospective study in COVID-19 patients recruited in our institution. The patients were divided into 2 groups depending on whether hospitalization was needed. Inpatients were subclassified into ward patients and those requiring intensive care. Thirty non-COVID-19 inpatients and 30 non-COVID-19 healthy individuals were recruited. VWF antigen, ADAMTS13 activity, D-dimer, and fibrinogen were measured during the first week once COVID-19 was diagnosed. Quantitative data were expressed as median (p25-p75) and qualitative data as percentage.
Results: Fifty COVID-19 inpatients (44% in the intensive care unit [ICU]) and 102 COVID-19 outpatients were enrolled. Inpatients were older and had a higher incidence of hypertension and diabetes. The COVID-19 inpatients had higher D-dimer, fibrinogen, and VWF antigen levels and a lower ADAMTS13 activity compared with the COVID-19 outpatients (p<0.05). ICU patients had higher D-dimer and VWF antigen levels compared with the ward patients and the lowest ADAMTS13 activity (p<0.05). An imbalance in VWF antigen/ADAMTS13 activity ratio was observed in COVID-19, reaching the highest in ICU patients. In contrast to other acute inflammatory diseases, a significative reduction in ADAMTS13 activity was observed in all COVID-19 patients.
Table 1
| Inpatients (n=50) | Outpatients (n=102) | |
| D-Dimer (µg/mL) | 2.48 (0.88–6.86) | 0.4 (0.27–0.56) p<0.05 |
| Fibrinogen (mg/dL) | 511 (395–568) |
346.5 (291–374) p<0.05 |
| ADAMTS13 activity (%) | 44.4 (32.5–60.8) | 59.9 (43.4–78.75) p<0.05 |
| VWF antigen (%) | 337.8 (270.0–394.9) |
121.6 (95.75–151.95) p<0.05 |
Hemostatic parameters: inpatients versus outpatients
Table 2
| Ward patients (n=28) | ICU patients (n=22) | |
| D-Dimer (µg/mL) | 0.89 (0.73–2.31) |
4.64 (2.66–11.04) p<0.05 |
| Fibrinogen (mg/dL) | 511 (383–561) |
505 (400–576) p<0.05 |
| ADAMTS13 activity(%) | 46.5 (40.4–60.9) | 38.85 (26–60) p<0.05 |
| VWF antigen (%) | 279.95 (217.15–345.15) |
368.6 (336.3–400) p<0.05 |
Hemostatic parameters: ward patients versus ICU patients
Conclusions: There is an increase in VWF antigen and an ADAMTS13 activity reduction in COVID-19 related to disease severity and could predict poor clinical outcomes. The ADAMTS13 activity reduction could be a marker associated with COVID-19 in contrast to other inflammatory conditions.
To cite this abstract in AMA style:
Marco A, Marco P. Von Willebrand Factor and ADAMTS13 Activity as Endothelial Injury Markers and their Prognostic Value in COVID-19 [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/von-willebrand-factor-and-adamts13-activity-as-endothelial-injury-markers-and-their-prognostic-value-in-covid-19/. Accessed December 5, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/von-willebrand-factor-and-adamts13-activity-as-endothelial-injury-markers-and-their-prognostic-value-in-covid-19/