High levels of von Willebrand factor with reduced specific activities in hospitalized patients with or without COVID-19

Abstract

The COVID-19 pandemic is often accompanied by severe respiratory illness and thrombotic complications. Von Willebrand Factor (VWF) levels are highly elevated in this condition. However, limited data are available on the qualitative activity of VWF in COVID-19. We measured plasma VWF levels quantitatively (VWF antigen) and qualitatively (ristocetin-induced platelet agglutination, glycoprotein IbM (GPIbM) binding, and collagen binding). Consistent with prior reports, VWF antigen levels were significantly elevated in hospitalized patients with or without COVID-19. The GPIbM and collagen binding activity-to-antigen ratios were significantly reduced, consistent with qualitative changes in VWF in COVID-19. Of note, critically ill hospitalized patients without COVID-19 had similar reductions in VWF activity-to-antigen ratios as patients with COVID-19. Our data suggest that qualitative changes in VWF in COVID-19 may not be specific to COVID-19. Future studies are warranted to determine the mechanisms responsible for qualitative changes in VWF in COVID-19 and other critical illnesses. • VWF levels were increased in COVID-19 compared to healthy controls. • VWF activity-to-antigen ratios were decreased in COVID-19 compared to healthy controls. • There were no differences in VWF activity-to-antigen ratios between hospitalized patients with or without COVID-19. • These findings are consistent with qualitative changes in VWF in systemic inflammation which are not specific to COVID-19. • Future studies are needed to define possible roles of changes in conformation or multimer length in the qualitative changes in VWF in systemic inflammation. Supplementary Information The online version contains supplementary material available at 10.1007/s11239-022-02679-5.

Endotheliopathy in Acute COVID-19 and Long COVID

“…Moreover, patients receiving haemodialysis with severe COVID-19 had significantly higher vWf plasma levels [42]. All studies agree that thrombin formation via the intrinsic coagulation pathway and vWf reflect disease severity and poor prognosis in COVID-19 patients [164][165][166][167].…”

“…Significantly higher plasma vWf levels in severe COVID-19 patients receiving haemodialysis [42]. Increased vWf levels reflect disease severity and a poor prognosis in COVID-19 patients [164][165][166][167].…”

Recombinant Rod Domain of Vimentin Reduces SARS-CoV-2 Viral Replication by Blocking Spike Protein–ACE2 Interactions

“…In addition to the pulmonary disease, patients infected with SARS-CoV-2 may also develop neurologic, renal, and cardiac complications [ 9 ]. These complications may be due to the pathologic activation of the coagulation [ 10 , 11 , 12 ] and inflammatory systems [ 13 , 14 ]; therefore, preventing infection through vaccination as well as limiting viral replication once infected are paramount to stop the spread of disease.…”