Vascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICU
Vascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICU
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DOI：
10.1097/mbc.0000000000001007
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发表时间：
2021-06-01
影响因子：
1.1
通讯作者：
de Laat, Bas
中科院分区：
文献类型：
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作者：
De Jongh, Raf;Ninivaggi, Marisa;de Laat, Bas
2019冠状病毒病（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，这些患者中有很大比例无法在感染后存活。此外，血管系统似乎也参与了发病机制。研究止血和内皮对入住ICU的COVID-19患者结局的作用。从16名ICU COVID-19患者中抽取血液进行止血分析。患者随访至出院（n = 11）或死亡（n = 5）。与凝血和纤溶相关的参数，虽然受到干扰，但与死亡率无关。首先，与存活者相比，非存活者中激活的Von Willebrand因子增加，ADAMTS 13水平降低2倍。我们的数据确定了血管性血友病因子-ADAMTS 13轴参与COVID-19发病机制，从而证明这些血浆蛋白似乎是ICU死亡率的强预测因子。
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.