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10.1111/bjh.17273

http://scihub22266oqcxt.onion/10.1111/bjh.17273
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33326604!ä!33326604

suck abstract from ncbi


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pmid33326604      Br+J+Haematol 2021 ; 192 (4): 714-719
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  • Von Willebrand factor propeptide in severe coronavirus disease 2019 (COVID-19): evidence of acute and sustained endothelial cell activation #MMPMID33326604
  • Ward SE; Curley GF; Lavin M; Fogarty H; Karampini E; McEvoy NL; Clarke J; Boylan M; Alalqam R; Worrall AP; Kelly C; de Barra E; Glavey S; Ni Cheallaigh C; Bergin C; Martin-Loeches I; Townsend L; Mallon PW; O'Sullivan JM; O'Donnell JS
  • Br J Haematol 2021[Feb]; 192 (4): 714-719 PMID33326604show ga
  • Endothelial cell (EC) activation plays a key role in the pathogenesis of pulmonary microvascular occlusion, which is a hallmark of severe coronavirus disease 2019 (COVID-19). Consistent with EC activation, increased plasma von Willebrand factor antigen (VWF:Ag) levels have been reported in COVID-19. Importantly however, studies in other microangiopathies have shown that plasma VWF propeptide (VWFpp) is a more sensitive and specific measure of acute EC activation. In the present study, we further investigated the nature of EC activation in severe COVID-19. Markedly increased plasma VWF:Ag [median (interquatile range, IQR) 608.8 (531-830)iu/dl] and pro-coagulant factor VIII (FVIII) levels [median (IQR) 261.9 (170-315) iu/dl] were seen in patients with severe severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Sequential testing showed that these elevated VWF-FVIII complex levels remained high for up to 3 weeks. Similarly, plasma VWFpp levels were also markedly elevated [median (IQR) 324.6 (267-524) iu/dl]. Interestingly however, the VWFpp/VWF:Ag ratio was reduced, demonstrating that decreased VWF clearance contributes to the elevated plasma VWF:Ag levels in severe COVID-19. Importantly, plasma VWFpp levels also correlated with clinical severity indices including the Sequential Organ Failure Assessment (SOFA) score, Sepsis-Induced Coagulopathy (SIC) score and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio). Collectively, these findings support the hypothesis that sustained fulminant EC activation is occurring in severe COVID-19, and further suggest that VWFpp may have a role as a biomarker in this setting.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Biomarkers/blood[MESH]
  • |COVID-19/*blood[MESH]
  • |Endothelial Cells/*metabolism/pathology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Protein Precursors/*blood[MESH]
  • |SARS-CoV-2/*metabolism[MESH]
  • |Severity of Illness Index[MESH]


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