Variation of endothelium‐related hemostatic factors during sepsis

Abstract

An ongoing endothelial/hemostatic disorder was established during sepsis, observed even at clinical improvement. Among the variables tested, protein C and ADAMTS-13 change were associated with outcome.

Involvement of ADAMTS13 and von Willebrand factor in thromboembolic events in patients infected with SARS‐CoV‐2

“…In contrast, vWF levels and factor VIII levels are increased, probably due to activated endothelium. 8 These data are in accordance with previously described results from patient with sepsis. 9 The interaction between injured vessel wall, vWF, and ADAMTS 13 might be potentially relevant in the pathophysiological coagulation changes seen in sepsis patients with microthrombosis as seen in disseminated intravascular coagulation and microangiopathy.…”

Reduction of ADAMTS13 Levels Predicts Mortality in SARS-CoV-2 Patients

“… 9 In the same scenario, ADAMTS13 was shown to be one of the endothelium-related markers showing changes, with a trend toward a reduction. 10 Furthermore, in response to the endothelial activation-induced vascular inflammation, reciprocal changes of the ADAMTS13 and its substrate, the von Willebrand factor (vWF), are observed. 11 …”

“…9 In the same scenario, ADAMTS13 was shown to be one of the endothelium-related markers showing changes, with a trend toward a reduction. 10 Furthermore, in response to the endothelial activation-induced vascular inflammation, reciprocal changes of the ADAMTS13 and its substrate, the von Willebrand factor (vWF), are observed. 11 In septic patients, reduced synthesis of protein C (PC) and its cofactor protein S (PS) in addition to impaired expression of thrombomodulin and endothelial PC receptor on endothelium determines reduced PC levels with an imbalance of thrombin regulation.…”

Emphasizing the Role of Endothelium-Related Hemostatic Factors in COVID-19 Sepsis

“…In addition to the above, we would also like to emphasize the clinical importance of another regulatory system, the thrombomodulin/protein C system, in preserving blood clotting homeostasis, and the functional integrity of microcirculation, which might be altered in sepsis. In a previous article published by our institute, 6 we found important abnormalities of thrombomodulin/protein C and VWF/ADAMTS13 ratios in septic ICU patients who presented deterioration, while protein C (> or ≤17%) and ADAMTS13 (> or ≤22%) percentage differences during ICU stay were independent predictors of sepsis outcome.…”