PB0075 - High plasma levels of activated factor VII-antithrombin complex indicate increased tissue factor expression/activation in patients with COVID-19.

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Nicola Martinelli, MD

Associate Professor of Internal Medicine
University of Verona
Verona, Veneto, Italy

Co-Author(s)

NO

Nicola Osti

Medical Doctor
University of Verona
Verona, Veneto, Italy
AR

Anna Maria Rigoni

Medical Doctor
Verona Hospital
Verona, Veneto, Italy
SD

Sergio De Marchi

Assistant Professor
University of Verona
Verona, Veneto, Italy
MM

Martina Montagnana

Associate Professor
University of Verona
Verona, Veneto, Italy
AC

Annalisa Castagna

PhD
University of Verona
Verona, Veneto, Italy
PP

Patrizia Pattini

Laboratory Technician
University of Verona
Verona, Veneto, Italy
SU

Silvia Udali

PhD
University of Verona
Verona, Veneto, Italy
LD

Lucia De Franceschi

Associate Professor
University of Verona
Verona, Veneto, Italy
ET

Elisa Tinazzi

Medical Doctor
University of Verona
Verona, Veneto, Italy
LD

Lorenzo Delfino

Medical Doctor
University of Verona
Verona, Veneto, Italy
GS

Giulia Sartori

Medical Doctor
University of Verona
Verona, Veneto, Italy
AA

Anna Maria Azzini

Assistant Professor
University of Verona
Verona, Veneto, Italy
ET

Evelina Tacconelli

Full Professor
University of Verona
Verona, Veneto, Italy
PV

Patrick Van Dreden

PhD clinical research manager
Clinical Research Department, Diagnostica Stago
Gennevilliers, Ile-de-France, France
GL

Giuseppe Lippi

Full Professor
University of Verona
Verona, Veneto, Italy
DG

Domenico Girelli

Full Professor
University of Verona
Verona, Veneto, Italy
OO

Oliviero Olivieri

Professor of Internal Medicine
University of Verona
Verona, Veneto, Italy
SF

Simonetta Friso

Associate Professor of Internal Medicine
University of Verona
Verona, Veneto, Italy
FP

Francesca Pizzolo

Associate Professor of Internal Medicine
University of Verona
Verona, Veneto, Italy

Background: The infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of coronavirus disease 2019 (COVID-19), is associated with coagulation abnormalities, in which endothelial injury/dysfunction may be a key pathogenic mechanism. Endothelial dysfunction triggers tissue factor (TF) expression. Activated factor VII-antithrombin (FVIIa-AT) complex is a potential biomarker of prothrombotic diathesis reflecting FVIIa-TF interaction.

Aims: To evaluate FVIIa-AT plasma levels in subjects with COVID-19 pneumonia.

Methods: FVIIa-AT plasma levels were assessed in 40 subjects (30 males and 10 females; 64.8 ± 12.3 years) admitted for COVID-19 pneumonia during the first pandemic wave in Italy (April 2020). FVIIa-AT levels were compared with those of two sex- and age-matched groups of hospitalized subjects without COVID-19, with or without laboratory signs of systemic inflammation. The concentration of FVIIa-AT was measured by ELISA on frozen citrate plasma samples. Data of coagulant activities of factor II (FII:c), factor V (FV:c), and factor VIII (FVIII:c) were available in a subgroup of subjects.

Results: Hospitalized COVID-19 patients had FVIIa-AT levels significantly higher than sex- and age-matched no COVID-19 subjects (Table 1), either with or without inflammation (P=0.013 and P=0.017 by ANOVA with Tukey post-hoc comparison, respectively). No difference in FVIIa-AT levels was observed between no COVID-19 subjects with or without inflammation (P=0.995). The association between COVID-19 and FVIIa-AT levels in the whole study sample remained significant by linear regression analysis adjusted for sex, age, C reactive protein, estimated glomerular filtration rate, fibrinogen, prothrombin time, and activated partial thromboplastin time (B coefficient 0.322 with standard error 0135, P=0.019). In sub-analysis COVID-19 patients showed also lower FII:c, FV:c, and FVIII:c levels (Table 1).

Conclusion(s): Our results indicate that SARS-CoV2 infection, at least during the first pandemic wave, was characterized by increased FVIIa-AT levels, thereby suggesting an increased FVIIa-TF interaction, which may be consistent with increased TF expression/activation due to SARS-CoV2 -induced endotheliopathy.