Ziekenhuis Oost Limburg, Genk, Belgium.
Synapse Research Institute, Maastricht, The Netherlands.
Blood Coagul Fibrinolysis. 2021 Jun 1;32(4):290-293. doi: 10.1097/MBC.0000000000001007.
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.
COVID-19 患者的呼吸衰竭是转诊至 ICU 的最常见原因之一。由于血栓栓塞并发症，这些患者中有相当大比例的人无法在感染中存活。此外，血管系统似乎也参与了发病机制。为了研究凝血和内皮在 ICU 收治的 COVID-19 患者预后中的作用，从 16 名 ICU COVID-19 患者中抽取血液进行止血分析。对患者进行随访，直至出院（n=11）或死亡（n=5）。尽管凝血和纤溶相关参数受到干扰，但与死亡率无关。相反，与幸存者相比，非幸存者的活化型血管性血友病因子增加，ADAMTS13 水平降低了两倍。我们的数据确立了血管性血友病因子-ADAMTS13 轴在 COVID-19 发病机制中的作用，从而表明这些血浆蛋白似乎是 ICU 死亡率的强有力预测指标。
