Journal of Blood Medicine (Aug 2021)

The Level of vWF Antigen and Coagulation Markers in Hospitalized Patients with Covid-19

  • Al Otair H,
  • AlSaleh K,
  • AlQahtany FS,
  • Al Ayed K,
  • Al Ammar H,
  • Al Mefgai N,
  • Al Zeer F

Journal volume & issue
Vol. Volume 12
pp. 809 – 817

Abstract

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Hadeel Al Otair,1 Khalid AlSaleh,2 Fatmah S AlQahtany,3 Khalid Al Ayed,1 Hessah Al Ammar,4 Noura Al Mefgai,4 Faisal Al Zeer5 1Department of Medicine, King Saud University Medical city (KSUMC), King Saud University, Riyadh, Saudi Arabia; 2Department of Medicine, Hematology/ oncology division, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Pathology, Hematopathology Unit, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia; 4Department of Medicine, King Saud University, Riyadh, Saudi Arabia; 5College of Medicine, King Saud University, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Hadeel Al OtairDepartment of Medicine, King Saud University Medical City, King Saud University, P.O. Box 2925(38), Riyadh, 11461, Saudi ArabiaTel +966(1) 8066519Fax +966(1) 4692365Email [email protected]: The coagulopathy of COVID-19 still awaits more clarification, and one approach that has not been investigated is to compare the hemostatic changes between COVID-19 and non-COVID-19 infected patients.Objective: This study aims to study COVID-19 coagulopathy by measuring markers of endothelial injury and coagulation, including anticoagulants (TFPI, protein C, protein S, and AT) in COVID-19 patients and compare them with non-COVID-19 patients early in the course of the disease.Methodology: This is an observational, prospective cross-sectional study comparing the levels of protein C, protein S, antithrombin (AT) III, clotting factor (F) VIII, von Willebrand factor (vWF) and coagulation screening tests (PT and a PTT), fibrinogen, D-dimer in COVID-19 patients admitted during the same time with non-COVID-19 infections. The demographic and clinical data of the patients were collected from electronic medical records during admission. Blood tests were extracted within 24 hours of admission for both groups.Results: Fifty-four (66.7% males) consecutive COVID-19 patients and 24 (59% males) non-COVID-19 controls were enrolled in the study from October 2020 till December 2020. COVID-19 patients were significantly older than non-COVID-19 (57.7± 14.2 vs 50± 19.8 years, p= 0.005). Fibrinogen level was significantly higher in COVID-19 patients compared to controls (5.9± 1.48 vs 3.9± 1.57, p< 0.001). There was no statistically significant difference in the level of FVIII, protein C, S, ATIII, and D-dimer between the two groups. The level of vWF Ag was statistically higher in COVID-19 patients (276.7± 91.1 vs 184.7± 89.4, p=0.0001). There was significant thrombocytopenia and lymphopenia among COVID-19 patients. Inflammatory markers, CRP, ferritin, and LDH, were increased in COVID-19 patients compared to non-COVID-19, but the difference was not statistically significant. High fibrinogen and vWF AG levels were the two independent variables found in COVID-19 patients.Conclusion: The level of vWF Ag is increased early in the course of COVID-19 infection. This can be used as a biomarker for endothelial injury, which is peculiar to COVID-19 infection.Keywords: COVID-19, vWF, fibrinogen, coagulopathy, endothelium

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