Alterations in von Willebrand Factor Levels in Patients with Malaria: A Systematic Review and Meta-Analysis of Disease Severity

<i>Background and Objectives</i>: Elevated von Willebrand factor (vWF) levels have been reported in malaria, but their relationship with disease severity remains unclear. This study aimed to compare vWF levels between <i>Plasmodium</i>-infected and uninfected individuals and...

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Main Authors: Suriyan Sukati, Rujikorn Rattanatham, Frederick Ramirez Masangkay, Ching-Ping Tseng, Manas Kotepui
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/4/767
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Summary:<i>Background and Objectives</i>: Elevated von Willebrand factor (vWF) levels have been reported in malaria, but their relationship with disease severity remains unclear. This study aimed to compare vWF levels between <i>Plasmodium</i>-infected and uninfected individuals and assess changes in severe infections. <i>Materials and Methods</i>: The systematic review was registered in PROSPERO (CRD42024558479). A comprehensive search across six databases identified studies reporting vWF levels in malaria. A meta-analysis was conducted using a random-effects model, with standardized mean difference (SMD) as the effect measure due to varying measurement units. Heterogeneity was assessed using the <i>I</i><sup>2</sup> statistic. <i>Results</i>: Of 1647 identified records, 26 studies met the inclusion criteria. The meta-analysis showed significantly higher vWF levels in <i>Plasmodium</i>-infected individuals compared to uninfected controls (<i>p</i> < 0.001, SMD: 2.689 [95% CI 1.362; 4.017], <i>I</i><sup>2</sup>: 98.1%, 12 studies, 3109 participants). However, no significant difference was found between severe and less severe cases (<i>p</i> = 0.051, SMD: 3.551 [95% CI −0.007; 7.109], <i>I</i><sup>2</sup>: 99.3%, 8 studies, 1453 participants). <i>Conclusions</i>: vWF levels are significantly elevated in individuals with <i>Plasmodium</i> infections, indicating a potential role in malaria pathophysiology. Although levels tend to be higher in severe cases, current evidence is insufficient to support vWF as a reliable marker for disease severity. Further prospective and well-controlled studies are needed to validate its diagnostic and prognostic value in malaria management.
ISSN:1010-660X
1648-9144