Circulating Endothelial Cells as a Marker of Endothelial Injury in Severe COVID -19

Abstract

Beside the commonly described pulmonary expression of the coronavirus disease 2019 (COVID-19), major vascular events have been reported. The objective of this study was to investigate whether increased levels of circulating endothelial cells (CEC) might be associated with severe forms of COVID-19. Ninety-nine patients with COVID-19 were enrolled in this retrospective study. Patients in the intensive care units (ICU) had significantly higher CEC counts than non-ICU patients and the extent of endothelial injury was correlated with putative markers of disease severity and inflammatory cytokines. Altogether, these data provide in vivo evidence that endothelial injury is a key feature of COVID-19.

Severe and Irreversible Pancytopenia Associated With SARS-CoV-2 Bone Marrow Infection in a Patient With Waldenstrom Macroglobulinemia

“…The patient also presented a major biological inflammatory syndrome (C-Reactive Protein: 298 mg/L, serum ferritin: 3965 μg/L and fibrinogen: 7.96 g/L) and increased plasma concentrations of Interleukin 6 (IL-6: 110 pg/mL) and Interferon gamma induced Protein 10 (IP-10: 1609 pg/mL). Besides, an endothelial injury was objective by an important elevation of the Circulating Endothelial Cells (261 elements/mL, normal rate < 10) in the peripheral blood, consistent with a severe form of COVID-19, as described in previous study 5 .…”

Angiogenesis, hereditary hemorrhagic telangiectasia and COVID-19

“…Thus, bevacizumab, a monoclonal antibody against VEGF, is used in an ongoing single-group trial (NCT04275414) in critical COVID-19 patients. Moreover, in a recent study including 99 hospitalized COVID-19 patients, those in the intensive care unit (ICU) had significantly higher circulating endothelial cells counts than non-ICU patients and were correlated with inflammatory cytokines levels [5]. These findings provide in vivo evidence that the extent of endothelial injury is correlated with disease severity and that endothelial injury is a key feature of COVID-19.…”

The COVID-19 Arterial Thromboembolic Complications: From Inflammation to Immunothrombosis Through Antiphospholipid Autoantibodies

“… 1 First, the endothelial cells suffer from a hyperinflammatory injury, as proven by the presence of exfoliated circulating elements. 2 , 3 On this basis, a “lymphocytic endotheliitis” may occur 4 ; however, in some circumstances, the vessel condition can seriously complicate toward a “leukocytoclastic vasculitis”, 5 consisting in a neutrophils infiltration inside the tunica media and adventitia, accompanied by fibrinoid necrosis ( Fig. 1 A and B).…”