Levels of von Willebrand factor (VWF) may be associated with thrombotic complications in patients with COVID-19, leading to the potential for therapies that target VWF, according to a review published in Chemico-Biological Interactions.

Coagulopathies, such as thrombosis, are a major concern as a leading cause of mortality with COVID-19. Numerous inflammatory coagulation biomarkers have been associated with COVID-19. VWF is a glycoprotein important to normal hemostasis and plays a large role in COVID-19 coagulopathies.

The authors revieweded how VWF is involved in thromboinflammatory comorbidities associated with COVID-19, including acute respiratory distress syndrome (ARDS) and thrombosis.

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In early stages of infection, patients with coagulopathy have elevated VWF, fibrinogen, factor VIII, elevated D-dimers, with minimal change in prothrombin time (PT), and activated partial thromboplastin time (aPTT).

The authors suggested that VWF levels in the blood could be related to clotting issues in patients with COVID-19.

“Essentially, the SARS-CoV-2 virus replication leads to damaged vessel walls,” the authors wrote in their report. “As a response to the damage, the body tries to patch the possible holes by releasing VWF into the blood. As a result, the risks of blood clotting increase.”

Multiple studies have found elevated VWF levels in patients with worse outcomes from COVID-19. The authors suggested VWF may be a target for treatment with VWF antibodies, anti-platelet drugs, aptamers, or other therapies that reduce VWF levels.


Choudhary S, Sharma K, Singh PK. Von Willebrand factor: A key glycoprotein involved in thrombo-inflammatory complications of COVID-19. Chem Biol Interact. 2021;348:109657. doi:10.1016/j.cbi.2021.109657