Observational studyInternational journal of laboratory hematology2021
ADAMTS13 activity to von Willebrand factor antigen ratio predicts acute kidney injury in patients with COVID-19: Evidence of SARS-CoV-2 induced secondary thrombotic microangiopathy.
Observational study in International journal of laboratory hematology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Prognostic value of von Willebrand factor and ADAMTS13 in patients with COVID-19: A systematic review and meta-analysis.Thrombosis research · 2022Pooled it
- High levels of Von Willebrand factor markers in COVID-19: a systematic review and meta-analysis.Clinical and experimental medicine · 2022Pooled it
- Biomarkers of endothelial dysfunction and outcomes in coronavirus disease 2019 (COVID-19) patients: A systematic review and meta-analysis.Microvascular research · 2021Pooled it
- Pregnancy-Associated Thrombotic Thrombocytopenic Purpura: Diagnostic Pitfalls, Therapeutic Strategies, and Emerging Paradigms.Biomedicines · 2026Review
- Insight to Neglected Biomarkers in COVID-19: A Comprehensive Narrative Review".Biomarker insights · 2026Review
- The impact of the COVID-19 pandemic on incidence and clinical presentation of thrombotic microangiopathies: data from a laboratory centralizing ADAMTS-13 testing in Quebec.Orphanet journal of rare diseases · 2025Article
- SARS-CoV-2 ORF7a activates the endothelium to release von Willebrand factor that promotes thrombosis.Research and practice in thrombosis and haemostasis · 2025Article
- ADAMTS13 or Caplacizumab Reduces the Accumulation of Neutrophil Extracellular Traps and Thrombus in Whole Blood of COVID-19 Patients under Flow.Thrombosis and haemostasis · 2024Article
- VWF/ADAMTS13 Ratio as a Potential Predictive Biomarker for Acute Kidney Injury Onset in Cirrhosis.Digestive diseases and sciences · 2024Article
- A Long-Term Follow-Up Study in Immune-Mediated Thrombotic Thrombocytopenic Purpura: What Are the Outcomes?Journal of clinical medicine · 2023Article
- A Moderate Decrease in ADAMTS13 Activity Correlates with the Severity of STEC-HUS.Biomolecules · 2023Article
- Dynamic Assessment of Plasma von Willebrand Factor and ADAMTS13 Predicts Mortality in Hospitalized Patients with SARS-CoV-2 Infection.Journal of clinical medicine · 2023Article
- Extracardiac Prothrombotic Effects of COVID-19.Heart failure clinics · 2023Review
- Automated and Rapid ADAMTS13 Testing Using Chemiluminescence: Utility for Identification or Exclusion of TTP and Beyond.Methods in molecular biology (Clifton, N.J.) · 2023Article
- An Overview of Laboratory Testing for ADAMTS13.Methods in molecular biology (Clifton, N.J.) · 2023Article
- Effects of convalescent plasma infusion on the ADAMTS13-von Willebrand factor axis and endothelial integrity in patients with severe and critical COVID-19.Research and practice in thrombosis and haemostasis · 2023Article
- Autoimmune Diseases Affecting Hemostasis: A Narrative Review.International journal of molecular sciences · 2022Review
- ADAMTS13 protease or lack of von Willebrand factor protects irradiation and melanoma-induced thrombotic microangiopathy in zebrafish.Journal of thrombosis and haemostasis : JTH · 2022Article
- Extracardiac Prothrombotic Effects of COVID-19.Cardiology clinics · 2022Review
- Vasculopathy in COVID-19.Blood · 2022Review
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 4 countries.
Funding
Abstract
introductionSevere COVID-19 is often compounded by a prothrombotic state that is associated with poor outcomes. In this investigation, we aimed to evaluate ADAMTS13 activity, von Willebrand factor level (VWF:Ag), and the corresponding ADAMTS13 activity/VWF:Ag ratio, in patients with COVID-19 and for associations with disease progression and acute kidney injury (AKI).
methodsPatients presenting to the emergency department (ED) with COVID-19 were enrolled in this prospective, observational study. ADAMTS13 activity and VWF:Ag were measured at index ED visit. The primary endpoint was severe AKI defined by KDIGO stage 2 + 3 criteria, while the secondary endpoint was peak 30-day COVID-19 severity.
resultsA total of 52 adult COVID-19 patients were enrolled. Overall, we observed that 23.1% of the cohort had a relative deficiency in ADAMTS13 activity, while 80.8% had elevated VWF:Ag. The ADAMTS13 activity/VWF:Ag ratio was significantly lower in patients with severe AKI (P = .002) and those who developed the severe form of COVID-19 (P = .020). The ADAMTS13 activity/VWF:Ag ratio was negatively correlated with age (P < .001) and LDH (P < .001), while positively correlated with hemoglobin (P = .041). After controlling for confounders, a one-unit increase in ADAMTS13/VWF:Ag ratio was associated with 20% decreased odds of severe AKI.
conclusionA low ADAMTS13 activity:VWF:Ag ratio at ED presentation is associated with progression to severe COVID-19 disease and severe AKI, with a pattern suggestive of a secondary microangiopathy. Further interventional studies should be conducted to assess the restoration of ADAMTS13:VWF:Ag ratio in hospitalized patients with COVID-19.
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