ArticleAngiogenesis2021
Circulating Von Willebrand factor and high molecular weight multimers as markers of endothelial injury predict COVID-19 in-hospital mortality.
Article in Angiogenesis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.
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Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it, 126 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
- Endotheliopathy marked by high von Willebrand factor (vWF) antigen in COVID-19 is associated with poor outcome: a systematic review and meta-analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Pooled it
- sST2 is a key outcome biomarker in COVID-19: insights from discovery randomized trial.Scientific reports · 2025Trial
- Phase 2 randomised placebo-controlled trial of spironolactone and dexamethasone versus dexamethasone in COVID-19 hospitalised patients in Delhi.BMC infectious diseases · 2023Trial
- Current Insights into Clinical, Molecular, and Therapeutic Approaches to Acute Respiratory Distress Syndrome.Medical sciences (Basel, Switzerland) · 2026Review
- Prediction of Functional Outcomes at Discharge Using Plasma Concentration of von Willebrand Factor Antigen at Admission in Hospitalized Patients with COVID-19.Annals of vascular diseases · 2026Article
- Long-Term Hemostatic and Endothelial Dysregulation Associated with Cardiovascular Events in Survivors of COVID-19 Previously Admitted to the ICU.International journal of molecular sciences · 2025Article
- Is COVID-19 Coagulopathy a Thrombotic Microangiopathy? A Prospective, Observational Study.International journal of molecular sciences · 2025Observational
- Relevance of anti-platelet factor 4/heparin antibodies and platelet activation in systemic inflammatory diseases and thrombosis disorders: insight from the COVID-19 pandemic.Research and practice in thrombosis and haemostasis · 2025Article
- Delineating sex-specific circulating host response signatures associated with COVID-19 severity and mortality.iScience · 2024Article
- The Onset of Intussusceptive Angiogenesis in COVID-19 Patients Might Come from the Mobilization of Stem Cell Sub-Populations Expressing the Hemangioblast Marker CD143.Stem cell reviews and reports · 2024Article
- Endothelial biomarkers (Von willebrand factor, BDCA3, urokinase) as predictors of mortality in COVID-19 patients: cohort study.BMC pulmonary medicine · 2024Article
- Molecular Research on Coronavirus: Pathogenic Mechanisms, Antiviral Drugs, and New Vaccines.International journal of molecular sciences · 2024Article
- VEGF-A plasma levels are associated with impaired DLCO and radiological sequelae in long COVID patients.Angiogenesis · 2024Article
- Circulating Von Willebrand factor: a consistent biomarker predicting in-hospital mortality across different waves of the COVID-19 pandemic.Angiogenesis · 2024Article
- CD147 Plasma Levels in Hospitalised Patients with Covid-19 Pneumonia Predict Illness Severity and In-Hospital Mortality.Stem cell reviews and reports · 2024Article
- Biomarkers of coagulation, endothelial, platelet function, and fibrinolysis in patients with COVID-19: a prospective study.Scientific reports · 2024Observational
- Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications.Hepatology forum · 2024Review
- COVID-19 and the Concept of Thrombo-Inflammation: Review of the Relationship between Immune Response, Endothelium and Coagulation.Journal of clinical medicine · 2023Review
- The modes of angiogenesis: an updated perspective.Angiogenesis · 2023Article
19 more citing papers are in PubMed but not listed here.
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Authors and funding
31 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCoronavirus disease 2019 (COVID-19) is a respiratory disease associated with endotheliitis and microthrombosis.
objectivesTo correlate endothelial dysfunction to in-hospital mortality in a bi-centric cohort of COVID-19 adult patients.
methodsConsecutive ambulatory and hospitalized patients with laboratory-confirmed COVID-19 were enrolled. A panel of endothelial biomarkers and von Willebrand factor (VWF) multimers were measured in each patient ≤ 48 h following admission.
resultsStudy enrolled 208 COVID-19 patients of whom 23 were mild outpatients and 189 patients hospitalized after admission. Most of endothelial biomarkers tested were found increased in the 89 critical patients transferred to intensive care unit. However, only von Willebrand factor antigen (VWF:Ag) scaled according to clinical severity, with levels significantly higher in critical patients (median 507%, IQR 428-596) compared to non-critical patients (288%, 230-350, p < 0.0001) or COVID-19 outpatients (144%, 133-198, p = 0.007). Moreover, VWF high molecular weight multimers (HMWM) were significantly higher in critical patients (median ratio 1.18, IQR 0.86-1.09) compared to non-critical patients (0.96, 1.04-1.39, p < 0.001). Among all endothelial biomarkers measured, ROC curve analysis identified a VWF:Ag cut-off of 423% as the best predictor for in-hospital mortality. The accuracy of VWF:Ag was further confirmed in a Kaplan-Meier estimator analysis and a Cox proportional Hazard model adjusted on age, BMI, C-reactive protein and D-dimer levels.
conclusionVWF:Ag is a relevant predictive factor for in-hospital mortality in COVID-19 patients. More than a biomarker, we hypothesize that VWF, including excess of HMWM forms, drives microthrombosis in COVID-19.
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