The vWF–ADAMTS13–Platelet Axis in COVID-19 Associated Coagulopathy and Organ Dysfunction

The field of thrombosis and haemostasis has been profoundly reshaped by insights from the COVID-19 pandemic, which revealed an unexpected interplay between viral infection, endothelial injury, and coagulation dynamics. Among these mechanisms, the imbalance between von Willebrand Factor (vWF) and its regulatory protease ADAMTS13 has emerged as a crucial determinant of microvascular thrombosis and organ injury in severe COVID-19. Current evidence suggests that elevated vWF release, coupled with impaired ADAMTS13 activity, contributes to the formation of ultra-large vWF multimers, platelet hyperactivation, and widespread immunothrombosis. Yet important questions remain unresolved — including whether ADAMTS13 deficiency is a primary driver or a secondary effect of systemic inflammation, and how this axis might contribute to post-acute vascular complications and long COVID pathology.This Research Topic aims to provide a comprehensive overview of the mechanistic, diagnostic, and therapeutic implications of the vWF–ADAMTS13–platelet axis in COVID-19. We seek to explore how this pathway modulates endothelial function, triggers microangiopathy, and sustains organ injury, as well as to identify new biomarkers and therapeutic opportunities. Contributions may include mechanistic studies, translational findings, clinical evidence, and reviews that collectively advance our understanding of coagulation-mediated organ dysfunction in SARS-CoV-2 infection.To gather further insights into COVID-19–related vascular pathology, we welcome submissions addressing, but not limited to, the following themes:-Mechanistic links between vWF dysregulation, ADAMTS13 depletion, and endothelial injury-Platelet activation, complement involvement, and immunothrombotic pathways-Diagnostic and prognostic roles of vWF and ADAMTS13 in COVID-19 and long COVID-Therapeutic targeting of the vWF–ADAMTS13 axis and anti-thrombotic interventions-Parallels between COVID-19–induced microangiopathy and other thrombotic disorders Topic editors: Rashid Kazmi, Bashir A Lwaleed Source: https://www.frontiersin.org/research-topics/81502/the-vwf-adamts13-platelet-axis-in-covid-19-associated-coagulopathy-and-organ-dysfunction