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...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-021-00333-3 |
| _version_ | 1819040980713603072 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-21T09:17:43Z |
| format | Article |
| id | doaj.art-937783ed553347d397a366637ca82f9d |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-21T09:17:43Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-937783ed553347d397a366637ca82f9d2022-12-21T19:09:07ZengBMCThrombosis Journal1477-95602021-11-011911910.1186/s12959-021-00333-3Low FXIII activity levels in intensive care unit hospitalized COVID-19 patientsYael Lichter0Tanya Badelbayov1Irina Shalev2Reut Schvartz3Yishay Szekely4Dan Benisty5Ilana Goldiner6Maxim Kagarlyk7Keren Asraf8Ram Doolman9Efrat Luttwak10Ilya Kirgner11Irit Avivi12Nimrod Adi13Ben-Zion Katz14The Intensive Care Unit, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterDivision of anesthesiology, Tel Aviv Sourasky Medical CenterThe Division of cardiology, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterThe Central Laboratory, Tel Aviv Sourasky Medical CenterThe Dworman Automated-Mega Laboratory, Sheba Medical CenterThe Dworman Automated-Mega Laboratory, Sheba Medical CenterThe Dworman Automated-Mega Laboratory, Sheba Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterThe Intensive Care Unit, Tel Aviv Sourasky Medical CenterThe Hematology Institute, Tel Aviv Sourasky Medical CenterAbstract 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.https://doi.org/10.1186/s12959-021-00333-3COVID-19FXIIIFVIII |
| spellingShingle | 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 Thrombosis Journal COVID-19 FXIII FVIII |
| title | 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_short | 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 |
| topic | COVID-19 FXIII FVIII |
| url | https://doi.org/10.1186/s12959-021-00333-3 |
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