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Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients

Authors :
Reut Schvartz
Keren Asraf
Yael Lichter
Ram Doolman
Maxim Kagarlyk
Yishay Szekely
Ilya Kirgner
Irina Shalev
Nimrod Adi
Ilana Goldiner
Ben-Zion Katz
Irit Avivi
Dan Benisty
Tanya Badelbayov
Efrat Luttwak
Source :
Thrombosis Journal, Vol 19, Iss 1, Pp 1-9 (2021), Thrombosis Journal
Publication Year :
2021
Publisher :
BMC, 2021.

Abstract

Background COVID-19 infection is associated with a hypercoagulable state. Severe COVID-19 patients present with high plasma fibrinogen levels, continuous deposition of fibrin and the presence of microthrombi in their lungs, accompanied by significant fibrinolysis, resulting in high D-dimer levels. Due to the role of FXIII in fibrin crosslinking and clot stabilization, we analyzed its activity levels and dynamics in COVID-19 patients hospitalized in the intensive care unit (ICU). Methods FXIII levels were measured in thirty four COVID-19 patients hospitalized in the ICU and in fourteen non-severe COVID-19 patients. FVIII levels were measured for comparison. Laboratory data and clinical variables were recorded. Results The average FXIII activity level in 34 ICU hospitalized COVID-19 patients was 69.9±33 %, significantly lower compared to an average of 120±20.9 % FXIII activity in 14 non-severe COVID-19 patients. FXIII activity levels were below the low normal value (< 79 % FXIII activity) in 74 % of the ICU hospitalized COVID-19 patients. In contrast, high FVIII activity was measured among all severe COVID-19 patients. Consecutive measurements, performed in fourteen ICU hospitalized COVID-19 patients, pointed to a significant decrease in FXIII activity from the average of 85.7±28.2 %, (which is in the normal range), to an average of 68.0±20.4 %, below the low normal range, within 6.4±3.4 days of ICU hospitalization. Liver functions did not differentiate between patients with low and normal FXIII activity. No inhibitor to FXIII activity was found in the plasma of severe COVID-19 patients. Levels of FXIII-A antigen correlated with FXIII activity, and were low in severe COVID-19 patients. Conclusions Low FXIII activity levels were found in COVID-19 patients hospitalized in the ICU, with gradual decline during their hospitalization. A mechanism of consumption may account for the low FXIII activity in these patients.

Details

Language :
English
ISSN :
14779560
Volume :
19
Issue :
1
Database :
OpenAIRE
Journal :
Thrombosis Journal
Accession number :
edsair.doi.dedup.....1bb4ebd56c029ba4af966453411e4aad