Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study
Background: Low ADAMTS13 activity has been suggested to be an interplaying factor in the pathogenesis of COVID-19, considering that it is a thromboinflammatory disease with high risk of microthrombosis. Objectives: The study aimed to explore the correlation between ADAMTS13 activity and the pathophy...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222000972 |
| _version_ | 1818356877307674624 |
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| author | Wael Hafez Mohamad Azzam Ziade Arun Arya Husam Saleh Sara Ali Srinivasa Raghu Rao Osman Fdl Alla Mohamed Ali Mouhamad Al Zouhbi Ahmed Abdelrahman |
| author_facet | Wael Hafez Mohamad Azzam Ziade Arun Arya Husam Saleh Sara Ali Srinivasa Raghu Rao Osman Fdl Alla Mohamed Ali Mouhamad Al Zouhbi Ahmed Abdelrahman |
| author_sort | Wael Hafez |
| collection | DOAJ |
| description | Background: Low ADAMTS13 activity has been suggested to be an interplaying factor in the pathogenesis of COVID-19, considering that it is a thromboinflammatory disease with high risk of microthrombosis. Objectives: The study aimed to explore the correlation between ADAMTS13 activity and the pathophysiological pathway of COVID-19. Methods: We carried out a retrospective observational study of 87 patients with COVID-19 in NMC Royal Hospital, Abu Dhabi, UAE. ADAMTS13 activity was measured and compared with patients’ characteristics and clinical outcomes. Results: Low ADAMTS13 activity was associated with pneumonia (p = 0.007), severity of COVID-19 (p <0.001), and mechanical ventilation rates (p = 0.018). Death was more frequently observed among patients (5 patients) with low ADAMTS13 activity compared with normal activity (1 patient), as well as inflammatory markers. Decreased ADAMTS13 activity increased with the risk of pneumonia, severity of COVID-19, need for mechanical ventilation, and use of anticoagulants ([OR = 4.75, 95% CI 1.54–18.02, p = 0.011], [OR = 6.50, 95% CI 2.57–17.74; p <0.001], [OR = 4.10, 95% CI 1.29–15.82; p = 0.024], [OR = 8.00, 95% CI 3.13–22.16; p <0.001], respectively). The low ADAMTS13 activity group had a slightly longer time to viral clearance than the normal ADAMTS13 activity group, but it was not statistically significant (20 days, 95% CI 16–27 days vs 17 days, 95% CI 13–22 days; p = 0.08; Log rank = 3.1). Conclusions: Low ADAMTS13 activity has been linked to pneumonia, COVID-19 severity, use of anticoagulants, and need for mechanical ventilation but not to mortality. We propose rADAMTS13 as a novel treatment for severe COVID-19. |
| first_indexed | 2024-12-13T20:04:11Z |
| format | Article |
| id | doaj.art-5306d44af2ef4632943721f9d42d21d6 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-13T20:04:11Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-5306d44af2ef4632943721f9d42d21d62022-12-21T23:33:05ZengElsevierInternational Journal of Infectious Diseases1201-97122022-04-01117334344Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational StudyWael Hafez0Mohamad Azzam Ziade1Arun Arya2Husam Saleh3Sara Ali4Srinivasa Raghu Rao5Osman Fdl Alla6Mohamed Ali7Mouhamad Al Zouhbi8Ahmed Abdelrahman9NMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab Emirates; Medical Research Division, Department of Internal Medicine, The National Research Centre, 33 El Buhouth St, Ad Doqi, Dokki, Cairo Governorate 12622, Egypt; Corresponding author: Wael Hafez. Consultant Internal Medicine, NMC Royal Hospital, 16 St, Khalifa City, Abu Dhabi, UAE, P.O. BOX 35233.Tel.: +97122035000; Mobile: +971561987354.NMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab EmiratesNMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, United Arab Emirates; Internal Medicine Department, Zagazig School of medicine, Zagazig, EgyptBackground: Low ADAMTS13 activity has been suggested to be an interplaying factor in the pathogenesis of COVID-19, considering that it is a thromboinflammatory disease with high risk of microthrombosis. Objectives: The study aimed to explore the correlation between ADAMTS13 activity and the pathophysiological pathway of COVID-19. Methods: We carried out a retrospective observational study of 87 patients with COVID-19 in NMC Royal Hospital, Abu Dhabi, UAE. ADAMTS13 activity was measured and compared with patients’ characteristics and clinical outcomes. Results: Low ADAMTS13 activity was associated with pneumonia (p = 0.007), severity of COVID-19 (p <0.001), and mechanical ventilation rates (p = 0.018). Death was more frequently observed among patients (5 patients) with low ADAMTS13 activity compared with normal activity (1 patient), as well as inflammatory markers. Decreased ADAMTS13 activity increased with the risk of pneumonia, severity of COVID-19, need for mechanical ventilation, and use of anticoagulants ([OR = 4.75, 95% CI 1.54–18.02, p = 0.011], [OR = 6.50, 95% CI 2.57–17.74; p <0.001], [OR = 4.10, 95% CI 1.29–15.82; p = 0.024], [OR = 8.00, 95% CI 3.13–22.16; p <0.001], respectively). The low ADAMTS13 activity group had a slightly longer time to viral clearance than the normal ADAMTS13 activity group, but it was not statistically significant (20 days, 95% CI 16–27 days vs 17 days, 95% CI 13–22 days; p = 0.08; Log rank = 3.1). Conclusions: Low ADAMTS13 activity has been linked to pneumonia, COVID-19 severity, use of anticoagulants, and need for mechanical ventilation but not to mortality. We propose rADAMTS13 as a novel treatment for severe COVID-19.http://www.sciencedirect.com/science/article/pii/S1201971222000972ADAMTS13ThrombosisSARS-CoV-2Cytokine stormCOVID-19Pneumonia |
| spellingShingle | Wael Hafez Mohamad Azzam Ziade Arun Arya Husam Saleh Sara Ali Srinivasa Raghu Rao Osman Fdl Alla Mohamed Ali Mouhamad Al Zouhbi Ahmed Abdelrahman Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study International Journal of Infectious Diseases ADAMTS13 Thrombosis SARS-CoV-2 Cytokine storm COVID-19 Pneumonia |
| title | Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study |
| title_full | Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study |
| title_fullStr | Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study |
| title_full_unstemmed | Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study |
| title_short | Reduced ADAMTS13 Activity in Correlation with Pathophysiology, Severity, and Outcome of COVID-19: A Retrospective Observational Study |
| title_sort | reduced adamts13 activity in correlation with pathophysiology severity and outcome of covid 19 a retrospective observational study |
| topic | ADAMTS13 Thrombosis SARS-CoV-2 Cytokine storm COVID-19 Pneumonia |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222000972 |
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