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Ann Vasc Dis . Prediction of Functional Outcomes at Discharge Using Plasma Concentration of von Willebrand Factor Antigen at Admission in Hospitaliz

tetano

Editor, Senior Moderator
Ann Vasc Dis


. 2026;19(1):25-00153.
doi: 10.3400/avd.oa.25-00153. Epub 2026 Feb 5.
Prediction of Functional Outcomes at Discharge Using Plasma Concentration of von Willebrand Factor Antigen at Admission in Hospitalized Patients with COVID-19

Masayuki Oki[SUP] 1 [/SUP], Daisuke Yamasawa[SUP] 1 [/SUP], Shinichi Goto[SUP] 1 [/SUP], Hidetaka Yanagi[SUP] 1 [/SUP], Saki Manabe[SUP] 1 [/SUP], Takako Kobayashi[SUP] 1 [/SUP], Ayumi Tsuda[SUP] 1 [/SUP], Shota Sato[SUP] 1 [/SUP], Seiji Morita[SUP] 2 [/SUP], Yoshihide Nakagawa[SUP] 2 [/SUP], Tsuyoshi Oguma[SUP] 3 [/SUP], Koichiro Asano[SUP] 3 [/SUP], Norio Yamamoto[SUP] 4 [/SUP], Hideki Ozawa[SUP] 1 [/SUP], Shinya Goto[SUP] 5 [/SUP]


Affiliations
Abstract

Objectives: Coronavirus disease 2019 (COVID-19) causes endothelial injury through inflammatory and hypoxic stress, leading to vascular dysfunction and immunothrombosis. The plasma level of von Willebrand factor (VWF) could serve as a biomarker of vascular injury. While elevated VWF predicts mortality in severe COVID-19, its relationship with post-discharge functional outcomes remains unclear. This study aimed to determine whether plasma VWF antigen (VWF:Ag) levels at admission predict functional status at discharge in patients hospitalized for COVID-19.
Methods: This was a single-center prospective cohort study conducted at Tokai University Hospital from July to September 2021. We evaluated the relationship between plasma VWF:Ag levels at admission and a Clinical Frailty Scale (CFS) score ≥4 at discharge using univariable and multivariable logistic regression analyses.
Results: A total of 97 patients were enrolled in the study. The median VWF:Ag level at admission was 330.0% (95% confidence interval [CI]: 273.0-391.8). Univariable analysis showed a significant association between elevated VWF:Ag levels and CFS score ≥4 at discharge. This association remained significant after adjusting for age and sex (odds ratio 1.010, 95% CI: 1.000-1.010, p = 0.005).
Conclusion: Elevated VWF:Ag levels at admission predict poor functional outcomes at discharge in COVID-19 patients, independent of age and sex.

Keywords: ADAMTS13; COVID-19; endothelial injury; functional outcome; von Willebrand factor.

 
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