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

Abstract Background COVID-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...

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Autores principales: Yael Lichter, Tanya Badelbayov, Irina Shalev, Reut Schvartz, Yishay Szekely, Dan Benisty, Ilana Goldiner, Maxim Kagarlyk, Keren Asraf, Ram Doolman, Efrat Luttwak, Ilya Kirgner, Irit Avivi, Nimrod Adi, Ben-Zion Katz
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Publicado: BMC 2021
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spelling oai:doaj.org-article:937783ed553347d397a366637ca82f9d2021-11-08T10:58:47ZLow FXIII activity levels in intensive care unit hospitalized COVID-19 patients10.1186/s12959-021-00333-31477-9560https://doaj.org/article/937783ed553347d397a366637ca82f9d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12959-021-00333-3https://doaj.org/toc/1477-9560Abstract Background COVID-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). Methods FXIII 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. Results The 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. Conclusions Low 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.Yael LichterTanya BadelbayovIrina ShalevReut SchvartzYishay SzekelyDan BenistyIlana GoldinerMaxim KagarlykKeren AsrafRam DoolmanEfrat LuttwakIlya KirgnerIrit AviviNimrod AdiBen-Zion KatzBMCarticleCOVID-19FXIIIFVIIIDiseases of the blood and blood-forming organsRC633-647.5ENThrombosis Journal, Vol 19, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic COVID-19
FXIII
FVIII
Diseases of the blood and blood-forming organs
RC633-647.5
spellingShingle COVID-19
FXIII
FVIII
Diseases of the blood and blood-forming organs
RC633-647.5
Yael Lichter
Tanya Badelbayov
Irina Shalev
Reut Schvartz
Yishay Szekely
Dan Benisty
Ilana Goldiner
Maxim Kagarlyk
Keren Asraf
Ram Doolman
Efrat Luttwak
Ilya Kirgner
Irit Avivi
Nimrod Adi
Ben-Zion Katz
Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
description Abstract Background COVID-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). Methods FXIII 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. Results The 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. Conclusions Low 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.
format article
author Yael Lichter
Tanya Badelbayov
Irina Shalev
Reut Schvartz
Yishay Szekely
Dan Benisty
Ilana Goldiner
Maxim Kagarlyk
Keren Asraf
Ram Doolman
Efrat Luttwak
Ilya Kirgner
Irit Avivi
Nimrod Adi
Ben-Zion Katz
author_facet Yael Lichter
Tanya Badelbayov
Irina Shalev
Reut Schvartz
Yishay Szekely
Dan Benisty
Ilana Goldiner
Maxim Kagarlyk
Keren Asraf
Ram Doolman
Efrat Luttwak
Ilya Kirgner
Irit Avivi
Nimrod Adi
Ben-Zion Katz
author_sort Yael Lichter
title Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
title_short Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
title_full Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
title_fullStr Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
title_full_unstemmed Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients
title_sort low fxiii activity levels in intensive care unit hospitalized covid-19 patients
publisher BMC
publishDate 2021
url https://doaj.org/article/937783ed553347d397a366637ca82f9d
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