Since the fi rst report of pneumonia outbreak in Wuhan by the end of 2019, Coronavirus Disease 2019 (COVID-19) has become a global pandemic; causing millions of deaths globally and aff ecting the rest of worldwide population. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which enters hosts by inhabiting Angiotensin-Converting Enzyme-2 (ACE-2) receptors expressed in the endothelium layer of not only the respiratory tracts, but also various organs in the body. COVID-19 has been reported to trigger multiple cardiovascular manifestations. Since endothelial dysfunction plays an important role in cardiovascular events and the endothelium is heavily involved in COVID-19 pathophysiology, it is important to investigate their associations and previously established drug potencies to improve endothelial functions as possible treatment options for COVID-19. In this review, we summarize endothelial dysfunction biomarkers involved in COVID-19 and drugs that have shown potential endothelial protective properties to better understand the incidence of endothelial dysfunction in COVID-19 and its future treatment. We searched in PubMed, Wiley Online Library, EBSCO, ScienceDirect databases for literatures containing following keywords: “Endothelial dysfunction”, “COVID-19”, and “biomarkers”. Eligible publications were then assessed and studied to comprise our literature review. A total of 96 studies matched our criteria and provided scientifi c evidences for our review. Materials were then compiled into a review summarizing endothelial biomarkers involved in COVID-19 and potentially repurposed drugs targeting endothelium for COVID-19.Various endothelial dysfunction biomarkers were found to be elevated in COVID19 and is found to be related to its severity, such as adhesion molecules, selectins, PAI-1, and von Willebrand Factors. Multiple drugs targeting the endothelium are also potential and some are under investigation for COVID-19.

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Objectives The incidence of hospitalization in Hajj pilgrims can be influenced by age, physical activity, and comorbidities, such as hypertension and diabetes melitus. Smoking, low levels of physical activity, cardiovascular, respiratory and endocrine metabolic diseases are the risk factors of mortality for Indonesian pilgrims. This study aims to identify the relationship between risk factors owned by pilgrims with hospitalization and mortality that occurs during the Hajj period. Methods This was a cross-sectional, non-intervention study with data retrieved from the pre-embarkation Hajj screening records. The diagnosis of hospitalization and cause of death during the Hajj period were obtained from the medical report and hospital/flight doctor death certificate. Results A total of 2933 eligible subjects were analyzed in this study, with 11 subjects having a history of hospitalization. The 11 subjects were over 50 years old with male (n=6, 54.5%) and women (n=5, 45.4%) having almost the same number. Bivariate analysis for comorbidities and laboratory outcomes resulted in diabetes melitus as the only comorbidity that increases the risk for hospitalization in Hajj pilgrims (p=0.035). There was no association between existing comorbidities with mortality during the Hajj period. Multivariate analysis using logistic regression showed that higher white blood cell levels were associated with higher risk of both hospitalization (p<0.001) and mortality (p<0.001) with mean value of 8030 ± 5290 mg/dl. Conclusions The risk factors associated with the hospitalization rate of pilgrims in Indonesia are a history of diabetes mellitus and higher white blood cell levels. Pilgrims with higher white blood cell levels with a mean value of 8030 ± 5290 mg/dl also have an increased risk of mortality during Hajj period.