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

Thrombosis Journal

Reut Schvartz¹  Ilana Goldiner²  Yishay Szekely³  Keren Asraf⁴  Maxim Kagarlyk⁴  Ram Doolman⁴  Efrat Luttwak⁵  Tanya Badelbayov⁵  Irina Shalev⁵  Dan Benisty⁵  Irit Avivi⁶  Ben-Zion Katz⁶  Ilya Kirgner⁶  Yael Lichter⁷  Nimrod Adi⁸ 

[1] Division of anesthesiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;The Central Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;The Division of cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel;The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel;The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel;Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;The Intensive Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;The Intensive Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;

关键词: COVID-19;    FXIII;    FVIII;   

DOI  :  10.1186/s12959-021-00333-3

来源: Springer

【 摘 要 】

BackgroundCOVID-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).MethodsFXIII 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.ResultsThe 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.ConclusionsLow 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.

【 授权许可】

CC BY