ArticleBlood advances2022
Impaired exercise capacity in post-COVID-19 syndrome: the role of VWF-ADAMTS13 axis.
Article in Blood advances, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Long COVID and endometriosis: a systematic review and meta-analysis.BMC women's health · 2025Pooled it
- Endotheliopathy in Acute COVID-19 and Long COVID.International journal of molecular sciences · 2023Pooled it
- The home-based breathing and chest mobility exercise improves cardiorespiratory functional capacity in long COVID with cardiovascular comorbidities: a randomized study.BMC cardiovascular disorders · 2024Trial
- Vascular inflammation in neuropsychiatric long COVID.Brain, behavior, & immunity - health · 2026Article
- Symptom burden, lung function, exercise tolerance and inflammation in patients post COVID-19: results from the prospective COVID-19 Chronic Morbidity (CCHROMO) study.BMC pulmonary medicine · 2026Article
- Increased physical performance after personalised physiotherapy and nutritional counselling in adults with post-COVID-19 condition: a feasibility randomised trial.Communications medicine · 2026Article
- Cardiovascular burden of long coronavirus disease: Clinical challenges and emerging biomarkers.World journal of cardiology · 2026Review
- Algorithm dependence of patient phenotypes in Long COVID: a patient-led, multi-method clustering of 6031 patients using 162 self-reported symptoms.Oxford open immunology · 2026Article
- Patient-reported treatment outcomes in ME/CFS and long COVID.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- LDHA-lactate axis modulates mitophagy inhibiting CSFV replication.Journal of virology · 2025Article
- Dexmedetomidine Reduces Chronic Stress-Related Thrombosis in a Mouse FeClFASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- Review
- Exploring Hypercoagulability in Post-COVID Syndrome (PCS): An Attempt at Unraveling the Endothelial Dysfunction.Journal of clinical medicine · 2025Article
- The endothelial-immunothrombotic storm in viral sepsis: lessons from COVID-19.Frontiers in immunology · 2025Review
- Identifying Factors That Might Affect Outcomes of Exercise-Based Therapies in Long-COVID.Diseases (Basel, Switzerland) · 2024Review
- The Highs and Lows of ADAMTS13 Activity.Journal of clinical medicine · 2024Review
- The Significance of Endothelial Dysfunction in Long COVID-19 for the Possible Future Pandemic of Chronic Kidney Disease and Cardiovascular Disease.Biomolecules · 2024Review
- Sex differences and immune correlates of Long COVID development, persistence, and resolution.bioRxiv : the preprint server for biology · 2024Article
- Challenging the current hypothesis that thrombosis is responsible for the post-COVID-19 condition.Research and practice in thrombosis and haemostasis · 2024Article
- Mechanisms of endothelial activation, hypercoagulation and thrombosis in COVID-19: a link with diabetes mellitus.Cardiovascular diabetology · 2024Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Post-COVID syndrome (PCS), or long COVID, is an increasingly recognized complication of acute SARS-CoV-2 infection, characterized by persistent fatigue, reduced exercise tolerance, chest pain, shortness of breath, and cognitive slowing. Acute COVID-19 is strongly linked with an increased risk of thrombosis, which is a prothrombotic state quantified by an elevated von Willebrand factor (VWF) antigen (Ag)/ADAMTS13 ratio that is associated with severity of acute COVID-19 infection. We investigated whether patients with PCS also had evidence of a prothrombotic state associated with symptom severity. In a large cohort of patients referred to a dedicated post-COVID-19 clinic, thrombotic risk, including VWF(Ag)/ADAMTS13 ratio, was investigated. An elevated VWF(Ag)/ADAMTS13 ratio (≥1.5) was present in nearly one-third of the cohort and was 4 times more likely to be present in patients with impaired exercise capacity, as evidenced by desaturation ≥3% and/or an increase in lactate level >1 from baseline on a 1-minute sit-to-stand test and/or a 6-minute walk test (P < .0001). Of 276 patients, 56 (20%) had impaired exercise capacity, of which 55% (31/56) had a VWF(Ag)/ADAMTS13 ratio ≥1.5 (P < .0001). Factor VIII and VWF(Ag) were elevated in 26% and 18%, respectively, and support a hypercoagulable state in some patients with PCS. These findings suggest possible ongoing microvascular/endothelial dysfunction in the pathogenesis of PCS and suggest a role for antithrombotic therapy in the treatment of these patients.
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Registered trials
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