Are TFPI and β-TG Indicators of Severity in COVID-19?


Background: In cases of severe coronavirus disease 2019 (COVID-19) affecting the lung, thromboembolic consequences have been described as a major pathologic event that poses a serious risk to life. This is supported by autopsy reports of alveolar destruction and pulmonary intravascular microthrombi. The brand-new coronavirus (CoV) doesn’t seem to have any inherent procoagulant properties. The inflammatory reaction is most likely what caused the coagulation abnormalities in COVID-19. Based on high interleukin-6 levels, COVID-19 exhibits significant inflammation (IL-6). Based on high D-dimer levels, this COVID-19-related inflammation causes coagulopathy (DD). According to COVID-19, an endotheliopathy appears to be a factor in microvascular thrombosis. This study’s objective is to confirm the coagulation anomalies in 100 patients with significant COVID-19 lung involvement and their relationship to the disease’s severity and prognosis.

Method: Indicators of inflammation, endothelial function, and coagulation were measured and compared between patients with severe and mild illness.

Results: Severe COVID-19 patients had higher levels of IL-6, TNF-a, TF, VWF, D-dimer, TAT, and fibrinogen. We also assessed -TG levels that were higher than the plasma levels of PF4 in patients with severe COVID-19, and we found that platelet adhesion was increased. This is because PF4 is rapidly removed from plasma. As compared to moderate COVID-19 patients, all severe COVID-19 patients had shortened CT and CFT, high MCF, and low LY at 30 minutes.

Conclusions: TFPI is said to be a natural anticoagulant that reduces coagulation and inflammation. As a result, we detected TFPI levels that were above normal without causing the inflammation and coagulation to stop, thereby demonstrating the clinical severity of individuals with severe COVID-19.



Author (s) Details

Rossella Cacciola

Hemostasis/Hematology Unit, Department of Experimental and Clinical Medicine, University of Catania-95123 Catania, Italy.

Elio Gentilini Cacciola

Policlinico “Umberto I”, Department of Public Health and Infectious Diseases, “Sapienza “ University of Rome-00182 Rome, Italy.

Veronica Vecchio

Hemoastasi/Hematology Unit, Medical School of Catania,University of Catania 95123 Catania, Italy.

Emma Cacciola

Hemostasis/Hematology Unit, Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy.


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Keywords –  COVID-19, inflammation, coagulation, TFPI, β-TG

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