1. Vascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICU.
- Author
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De Jongh R, Ninivaggi M, Mesotten D, Bai C, Marcus B, Huskens D, Stragier H, Miszta A, Verbruggen J, de Laat-Kremers RMW, Grieten J, and de Laat B
- Subjects
- ADAMTS13 Protein deficiency, Aged, Aged, 80 and over, Biomarkers, Blood Proteins analysis, COVID-19 complications, COVID-19 mortality, Cross-Sectional Studies, Endothelium, Vascular metabolism, Extracorporeal Circulation, Female, Fibrinolysin biosynthesis, Fibrinolysis, Hemostasis, Heparin therapeutic use, Humans, Intensive Care Units, Male, Middle Aged, Partial Thromboplastin Time, Prognosis, Thrombin biosynthesis, ADAMTS13 Protein blood, COVID-19 blood, Endothelium, Vascular physiopathology, SARS-CoV-2 isolation & purification, von Willebrand Factor analysis
- Abstract
Respiratory failure in coronavirus disease 2019 (COVID-19) patients is one of the most frequent causes for referral to the ICU. A significant percentage of these patients does not survive the infection due to thromboembolic complications. Furthermore, the vascular system seems also to be involved in the pathogenesis. To investigate the role of hemostasis and endothelium on the outcome of COVID-19 patients admitted to the ICU. Blood was drawn from 16 ICU COVID-19 patients for hemostatic analysis. Patients were followed-up till discharge (n = 11) or death (n = 5). Parameters related to both coagulation and fibrinolysis, though disturbed, were not associated with mortality. Contrarily, activated Von Willebrand factor was increased and ADAMTS13 levels were decreased by two-fold in nonsurvivors compared with survivors. Our data established the involvement of the Von Willebrand factor-ADAMTS13 axis in the COVID-19 pathogenesis, thereby demonstrating that these plasma proteins seem to be strong predictors for ICU mortality., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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