Factor VIII and Functional Protein C Activity in Critically Ill Patients With Coronavirus Disease 2019: A Case Series

A A Pract. 2020 May;14(7):e01236. doi: 10.1213/XAA.0000000000001236.

Abstract

Critically ill patients with coronavirus disease 2019 (COVID-19) have been observed to be hypercoagulable, but the mechanisms for this remain poorly described. Factor VIII is a procoagulant factor that increases during inflammation and is cleaved by activated protein C. To our knowledge, there is only 1 prior study of factor VIII and functional protein C activity in critically ill patients with COVID-19. Here, we present a case series of 10 critically ill patients with COVID-19 who had severe elevations in factor VIII activity and low normal functional protein C activity, which may have contributed to hypercoagulability.

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Antithrombins / metabolism
  • Betacoronavirus
  • C-Reactive Protein / metabolism
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / blood*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy
  • Critical Illness
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / epidemiology
  • Extracorporeal Membrane Oxygenation
  • Factor VIII / metabolism*
  • Female
  • Ferritins / metabolism
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Fibrinogen / metabolism
  • Humans
  • Hypertension / epidemiology
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Pandemics
  • Partial Thromboplastin Time
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy
  • Protein C / metabolism*
  • Prothrombin Time
  • Renal Dialysis
  • Renal Insufficiency, Chronic / epidemiology
  • Respiration, Artificial
  • Respiratory Distress Syndrome / blood*
  • Respiratory Distress Syndrome / epidemiology
  • Respiratory Distress Syndrome / therapy
  • SARS-CoV-2
  • Thrombophilia / blood*

Substances

  • Antithrombins
  • Fibrin Fibrinogen Degradation Products
  • Protein C
  • fibrin fragment D
  • Factor VIII
  • Fibrinogen
  • C-Reactive Protein
  • Ferritins