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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2021
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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) |
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COVID-19 FXIII FVIII Diseases of the blood and blood-forming organs RC633-647.5 |
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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 |
work_keys_str_mv |
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