• Medicine · Apr 2024

    Evaluating the potential mediating role of ADAMTS13 activity in the relationship between obesity and the severity of COVID-19: A retrospective cohort study.

    • Wael Hafez, Asrar Rashid, Hesham Mohamed Abuelsaoud, Mohan Jose, Samy Kishk, Muneir Gador, Tesfalidet Emoshe, Fatema Abdulaal, Nivedita Nair, Muhammad Ahmad, Vanya Jalal Rashid, Youmna Faheem, Steffi John, Sabah Ahmed, Ahmed Daraghmi, Rami Soliman, Ahmed Abdelrahman, Ahmed Ali Mohamed, and Mirvat Ghanem.
    • NMC Royal Hospital, Khalifa City, Abu Dhabi, United Arab Emirates.
    • Medicine (Baltimore). 2024 Apr 12; 103 (15): e37806e37806.

    AbstractObesity and low enzyme A disintegrin and metalloproteinase with thrombospondin type-1 motif-13 (ADAMTS13) activity have been linked to poor coronavirus disease 2019 (COVID-19). Given that obesity may influence ADAMTS13 activity, it is feasible; however, it remains unclear whether ADAMTS13 activity acts as a mediator between obesity and COVID-19 outcomes. We investigated the link between body mass index (BMI) and COVID-19 outcomes, using ADAMTS13 activity as a mediator. ADAMTS13 activity was measured in 86 hospitalized COVID-19 patients. BMI, ADAMTS13 activity, and COVID-19 outcomes were assessed. Obese patients had a high odds ratio for low ADAMTS13 levels. When different levels of ADAMTS13 activity were considered, the severity of COVID-19 in obese patients was 4.5 times that in the normal BMI group. Furthermore, increased coagulopathy indicators correlated with low ADAMTS13 activity. Patients with elevated ALT and AST levels showed a 3 to 4-fold increase in the chances of low ADAMTS13 activity (OR:3.19, 95% CI:1.22-8.90, P = .021; OR:2.17, 95% CI:0.91-5.27, P = .082, respectively). When ADAMTS13 activity was considered, obese patients had greater COVID-19 severity and slower viral clearance than those with normal BMI. Low ADAMTS13 activity and impaired liver function are associated with poor COVID-19 outcomes. These findings encourage researchers to use molecular component identification to study the effects of obesity on the von Willebrand factor (VWF)/ADAMTS13 axis, COVID-19 pathogenesis, and outcomes.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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