COVID and blood cells

Identifying high-risk COVID-19 patients

  • Research

A blood marker that may help to identify COVID-19 patients at risk of a poorer prognosis has been identified by researchers at RCSI University of Medicine and Health Sciences.

The study found a link between elevated levels of the blood marker, von Willebrand factor propeptide, and the occurrence of more severe thrombotic and respiratory complications associated with the disease.

Doctors throughout the world have been puzzled as to the mechanisms through which COVID-19 triggers the formation of micro-clots in the lungs, known to lead to an increased risk of intensive care admission and poorer outcomes for patients. The research analysed the mechanism for the development of blood clotting abnormalities in COVID-19 patients and found a link to von Willebrand factor propeptide.

Von Willebrand factor propeptide is an established blood marker for damage to the endothelial cells lining the blood vessels in the body. Acute damage of these cells results in the rapid release of von Willebrand factor propeptide but also initiates clot formation and inflammation. The study found that the highest levels of the blood marker were found in patients with the most severe cases of COVID-19 or those who died with the disease.

These findings provide insight into the biology underpinning clot formation in patients with severe COVID-19 and may help clinicians to stratify patients at high risk of developing complications that will affect prognosis and outcomes.

The research is published in the British Journal of Haematology and led by Professor James O'Donnell, Director of the Irish Centre for Vascular Biology, RCSI and Consultant Haematologist in the National Coagulation Centre in St James’s Hospital. Professor O'Donnell and his team are now undertaking further studies into mechanisms contributing to clot formation in COVID-19 patients.

The research was funded through the Irish COVID-19 Vasculopathy Study (ICVS) via the Health Research Board COVID-19 Rapid Response Awards (COV19-202-086) and a philanthropic grant from 3M.