Von Willebrand Factor (vWF): marker of endothelial damage and thrombotic risk in COVID-19?

Ladikou, Eleni E, Sivaloganathan, Helena, Milne, Kate M, Arter, William E, Ramasamy, Roshan, Saad, Ramy, Stoneham, Simon M, Phillips, Barbara, Eziefula, Alice C and Chevassut, Timothy (2020) Von Willebrand Factor (vWF): marker of endothelial damage and thrombotic risk in COVID-19? Clinical Medicine. pp. 1-5. ISSN 1470-2118

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Background COVID-19 infection is characterised, among other features, by a prothrombotic state with high rate of venous thromboembolism (VTE), D-dimer, and fibrinogen levels. Clinical observations have also highlighted that these patients have elevated von Willebrand factor (vWF) and factor VIIIc.

Methods 24 consecutive COVID-19 positive patients were selected from the intensive care unit (ICU) or the high acuity ward of Brighton and Sussex University Hospitals NHS Trust.

Results The rate of VTE was 25% and mortality rate was 16.7%. Fibrinogen and D-Dimers were elevated, 7.9 (1.6) g/L and 2.4 (2.02) ug/ml respectively. Factor VIIIc and von vWF antigen levels were both extremely elevated at 279 (148) u/dL and 350 (131) % respectively, which are comparable to levels seen in ICU patients with severe sepsis. vWF levels were significantly higher in patients that died (p=0.017) and showed a positive correlation with age. There was a statistically significant association between COVID-19 disease and non-O blood group (p=0.02); 80% (4/5) of COVID-19 patients with VTE were blood group A.

Conclusion Very high levels of vWF and factor VIIIc are common in COVID-19 patients, comparable to levels in severely septic non-COVID ICU patients. This could contribute to the hypercoagulable state and increased VTE rate in COVID-19. Further studies are needed to evaluate the use of vWF for stratifying thrombotic risk in COVID-19 and to determine if elevated vWF is contributing to disease pathogenesis.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine
R Medicine > RB Pathology
R Medicine > RB Pathology > RB151 Theories of disease. Etiology. Pathogenesis
Depositing User: Timothy Chevassut
Date Deposited: 10 Jul 2020 10:25
Last Modified: 23 Jul 2020 12:45
URI: http://sro.sussex.ac.uk/id/eprint/92472

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