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Factor V Activity Significantly Increased in Severe COVID-19

TUESDAY, Sept. 15, 2020 -- Factor V activity is significantly increased in patients with severe COVID-19, according to a study published online Aug. 24 in the American Journal of Hematology.

Jonathan A. Stefely, M.D., Ph.D., 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 percent, 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 versus 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 versus 13 percent). 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.

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