(HealthDay News) — Factor V activity is significantly increased in patients with severe COVID-19, according to a study published online in the American Journal of Hematology.
Jonathan A. Stefely, MD, PhD, from Massachusetts General Hospital in Boston, and colleagues measured factor V, VIII, and X activity in a cohort of 102 consecutive inpatients with COVID-19; the cohort represented severe COVID-19, with high rates of ventilator use, line clots, deep vein thrombosis or pulmonary embolism (DVT/PE), and mortality (92, 47, 23, and 22%, respectively). In addition, contemporaneous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls and historical prepandemic controls were analyzed.
The researchers found that compared with contemporaneous controls, in COVID-19, factor V activity was significantly elevated (median, 150 vs 105 IU/dL). Significantly higher rates of DVT/PE were seen for patients with COVID-19 and factor V activity >150 IU/dL compared with those with factor V activity ≤150 IU/dL (33 vs 13%). Factor V activity was associated with SARS-CoV-2 viral load in a sex-dependent manner within the cohort. Subsequent reductions in factor V were associated with progression to disseminated intravascular coagulation and mortality.
“Our study reveals factor V perturbations as a previously unrecognized feature of severe COVID-19, adds a mechanistic candidate to ongoing investigations of COVID-19 coagulopathy with potential links to SARS-CoV-2 disease biology, and provides a foundation for future studies of COVID-19 coagulopathy diagnosis and biomarkers for guiding anticoagulation therapy in severe COVID-19,” the authors write.
Stefely JA, Christensen BB, Gogakos T, et al. Marked factor V activity elevation in severe COVID‐19 is associated with venous thromboembolism. Am J Hematol. doi:10.1002/ajh.25979