Abstract：
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causal agent of coronavirus disease 2019 (COVID-19), in which coagulation abnormalities and endothelial dysfunction play a key pathogenic role. Tissue factor (TF) expression is triggered by endothelial dysfunction. Activated factor VII-antithrombin (FVIIa-AT) complex reflects indirectly FVIIa-TF interaction and has been proposed as a potential biomarker of prothrombotic diathesis. FVIIa-AT plasma concentration was measured in 40 patients (30 males and 10 females; 64.8 ± 12.3 years) admitted with SARS-CoV-2 pneumonia during the first pandemic wave in Italy. Two sex- and age-matched cohorts without COVID-19, with or without signs of systemic inflammation, were used to compare FVIIa-AT data. The FVIIa-AT plasma levels in COVID-19 patients were higher than those in non-COVID-19 subjects, either with or without inflammation, while no difference was observed among non-COVID-19 subjects. The association between COVID-19 and FVIIa-AT levels remained significant after adjustment for sex, age, C-reactive protein, renal function, fibrinogen, prothrombin time and activated partial thromboplastin time. Our results indicate that SARS-CoV-2 infection, at least during the first pandemic wave, was characterized by high FVIIa-AT levels, which may suggest an enhanced FVIIa-TF interaction in COVID-19, potentially consistent with SARS-CoV-2-induced endotheliopathy.
摘要：
严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）是2019年冠状病毒病（COVID-19）的病因，其中凝血异常和内皮功能障碍起关键致病作用。组织因子(TF)表达由内皮功能障碍触发。激活的因子VII-抗凝血酶（FVIIa-AT）复合物间接反映了FVIIa-TF的相互作用，并被认为是血栓形成前素质的潜在生物标志物。在意大利的第一波大流行浪潮中，对40例SARS-CoV-2肺炎患者（30例男性和10例女性；64.8±12.3年）的FVIIa-AT血浆浓度进行了测量。两个性别和年龄匹配的队列，没有COVID-19，有或没有全身炎症的迹象，用于比较FVIIa-AT数据。COVID-19患者血浆FVIIa-AT水平高于非COVID-19患者，有或没有炎症，而在非COVID-19受试者中没有观察到差异。在调整性别后，COVID-19和FVIIa-AT水平之间的关联仍然显著，年龄,C反应蛋白,肾功能,纤维蛋白原，凝血酶原时间和活化部分凝血活酶时间。我们的结果表明SARS-CoV-2感染，至少在第一波大流行期间，其特点是高FVIIa-AT水平，这可能表明COVID-19中的FVIIa-TF相互作用增强，可能与SARS-CoV-2诱导的内皮病一致。
