SHORT COMMUNICATIONSVascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICUDe Jongh, Rafa; Ninivaggi, Marisab; Mesotten, Dietera; Bai, Cuib; Marcus, Berenda; Huskens, Danab; Stragier, Hendrika; Miszta, Adamb; Verbruggen, Jasminea; de Laat-Kremers, Romy M.W.b; Grieten, Jefa; de Laat, BasbAuthor Information aZiekenhuis Oost Limburg, Genk, Belgium bSynapse Research Institute, Maastricht, The Netherlands Correspondence to Marisa Ninivaggi, PhD, Synapse Research Institute, Pastoor Habetsstraat 50, 6217 KM, Maastricht, The Netherlands Tel: +31 43 303 0693; e-mail: [email protected] Received 28 September, 2020 Revised 12 November, 2020 Accepted 2 December, 2020 Blood Coagulation & Fibrinolysis: June 2021 - Volume 32 - Issue 4 - p 290-293 doi: 10.1097/MBC.0000000000001007 Buy Metrics Abstract Respiratory failure in coronavirus disease 2019 (COVID-19) patients is one of the most frequent causes for referral to the ICU. A significant percentage of these patients does not survive the infection due to thromboembolic complications. Furthermore, the vascular system seems also to be involved in the pathogenesis. To investigate the role of hemostasis and endothelium on the outcome of COVID-19 patients admitted to the ICU. Blood was drawn from 16 ICU COVID-19 patients for hemostatic analysis. Patients were followed-up till discharge (n = 11) or death (n = 5). Parameters related to both coagulation and fibrinolysis, though disturbed, were not associated with mortality. Contrarily, activated Von Willebrand factor was increased and ADAMTS13 levels were decreased by two-fold in nonsurvivors compared with survivors. Our data established the involvement of the Von Willebrand factor-ADAMTS13 axis in the COVID-19 pathogenesis, thereby demonstrating that these plasma proteins seem to be strong predictors for ICU mortality. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.