How does blood clotting impact outcomes among COVID - 19 patients?
- Sanya
- Oct 17, 2020
- 2 min read
Coagulation, more commonly known as blood clotting, is the process by which blood changes from a liquid to a gel-like state, forming a clot. This mechanism is typically used by the body to prevent an individual from bleeding out after an injury. Based on a study published in the American Journal of Hematology, impairments in the coagulation process can increase the risk of death among COVID-19 patients. On measuring several blood clotting factors, including factor five, ten and eight, factor five activity was greatly increased in the patients and this was the strongest association compared to any other parameter. The study hypothesized that the elevation in factor V activity is associated with COVID-19.
Out of the 102 samples used in the study, 48% of these cases had factor V above the reference range of 60-150 IU/dL. When these results were compared to patients tested in the lab 4 years before the pandemic, factor V was significantly greater in patients severe COVID-19.
It is typically found that when factor V activity is elevated, there is an increased risk of blood clotting in the extremities resulting in deep vein thrombosis (DVT) or in the lung, resulting in pulmonary embolism (PE). Similar associations were found in severe COVID-19 patients who had increased factor V activity.
Factor VIII is another coagulation factor that shows increased levels of activity among patients with COVID-19 but there didn’t seem to be any correlation with factor V. The activity of factor X was also measured as it interacts with activated factor V, but its activity was not altered in COVID-19 cases. Other coagulation parameters were also analyzed and it was found that there is an elevation of D-dimer and fibrinogen in COVID-19 cases.
A possible explanation for increased factor V activity could be the fact that in COVID-19 patients, megakaryocytes are abundant in lungs, heart and other organs. Since megakaryocytes produce platelets which contain 20-25% of factor V in blood, it could contribute to the high levels of factor V.
These findings open up new avenues and require more research in anticoagulation therapies targeting factor V.
By: Sanya Bansal
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