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Hamostaseologie 2025; 45(06): 490-496
DOI: 10.1055/a-2238-4744
Original Article

Assessment of Factor VIII Activity and D-Dimer Levels in the Post-COVID Period

Authors

  • Mirjana Kovac

    1   Faculty of Medicine, University of Belgrade, Belgrade, Serbia
    2   Department of Hemostasis, Blood Transfusion Institute of Serbia, Belgrade, Serbia

  • Milena Todorovic Balint

    1   Faculty of Medicine, University of Belgrade, Belgrade, Serbia
    3   Clinic for hematology, University Clinical Centre of Serbia, Belgrade, Serbia

  • Marija Milenkovic

    1   Faculty of Medicine, University of Belgrade, Belgrade, Serbia
    4   Emergency Centre, University Clinical Centre of Serbia, Belgrade, Serbia

  • Dusica Basaric

    2   Department of Hemostasis, Blood Transfusion Institute of Serbia, Belgrade, Serbia

  • Branko Tomic

    5   Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia

  • Bela Balint

    1   Faculty of Medicine, University of Belgrade, Belgrade, Serbia
    6   Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia

  • Vera Ignjatovic

    7   Johns Hopkins All Children's Institute for Clinical and Translational Research, United States
    8   Johns Hopkins University School of Medicine, St. Petersburg, Florida, United States

Funding This study was supported by grant 451-03-47/2023-01/200042 from the Ministry of Science, Technological Development and Innovations, Serbia.
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Abstract

Changes in the hemostatic system during COVID infection lead to hypercoagulability. Numerous studies have evaluated hemostatic abnormalities in COVID patients during acute infection, in the period of hospitalization. However, the hemostatic status following hospital discharge has not been sufficiently assessed. Considering the importance of FVIII and D-dimer levels as markers for the assessment of thrombosis, our study aimed to evaluate changes in these markers, as well as the influence of patient's age and clinical presentation of COVID infection on those hemostatic markers in the post-COVID phase. This prospective study (July 2020 to December 2022) included 115 COVID patients, 68 (59%) with asymptomatic/mild and 47 (41%) with moderate/severe clinical presentation. Patient follow-up included laboratory evaluation of FVIII and D-dimer levels at 1, 3, and 6 months following the COVID infection. Three months after the COVID infection, elevated FVIII was recorded in 44% of younger versus 65% of older individuals, p = 0.05, respectively, and 30 versus 57% (p = 0.008) 6 months post–COVID infection. With a focus on clinical presentation, a higher number of patients with moderate/severe COVID had elevated FVIII activity, but a statistically significant difference was observed only for the 6 months (32% mild vs. 53% moderate/severe, p = 0.041) post-infection time point. Following a COVID infection, an increase in FVIII activity suggests a continued hypercoagulable state in the post-COVID period and correlates with elevated D-dimer levels. This increase in FVIII is more pronounced in patients with moderate/severe clinical picture and those patients older than 50 years.

Keywords

hypercoagulability - venous thrombosis - infectious diseases - factor VIII


Publication History

Received: 12 June 2023

Accepted: 03 January 2024

Article published online:
01 March 2024

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