COVID-19 increases extracorporeal coagulation during hemodialysis through upregulation of vWF/FBNL5 signaling|COVID-19数据集|凝血机制数据集

Introduction: COVID-19 has been shown to increase the risk of extracorporeal coagulation during hemodialysis in patients, but the mechanism is unclear. This study aims to investigate the effect and mechanism of COVID-19 on the risk of extracorporeal coagulation during hemodialysis. Methods: A retrospective analysis was performed on the extracorporeal coagulation status of 339 hemodialysis patients at our hemodialysis center before and after COVID-19 infection. Protein spectroscopy was used to analyze blood composition differences between asymptomatic/mild and severe/critical patients after infection. Results: In comparison to the pre-COVID-19 infection period, a notable increase in the risk of extracorporeal coagulation during hemodialysis after infection has been observed. The grade of coagulation was directly proportional to the severity of infection symptoms, especially in severe and critically symptoms patients. In addition, proteomic analysis has demonstrated that in severe/critical cases, the coagulation cascade reaction, platelet activation, inflammation, and oxidative stress-related signals were significantly amplified as compared to asymptomatic/mild cases. Notably, the coagulation-related signaling pathway vWF/FBNL5 was significantly upregulated. Conclusions: In conclusion, this study revealing the potential role of vWF/FBNL5 in COVID-19-induced coagulation, which can have severe implications for patients undergoing hemodialysis. The findings highlight the critical importance of early initiation of anticoagulant therapy for COVID-19 patients, particularly those undergoing hemodialysis.