Critical COVID-19 represents an endothelial disease with high similarity to kidney disease on the molecular level

Abstract

In patients with critical or mild COVID19 (WHO stages 6-8 [n=53] and stages 1-3 [n=66]), 593 urinary peptides significantly affected by disease severity were identified, reflecting the molecular pathophysiology associated with the course of the infection. The peptide profiles were similar compared with those observed in kidney disease, a prototype of target organ damage with major microvascular involvement, thereby confirming the observation that endothelial damage is a hallmark of COVID19. The clinical corollary is that COVID19 is an indication for anti-oxidative, anti-inflammatory and immunosuppressive treatment modalities protecting the endothelial lining.

Urinary peptides predict future death

“…This classifier, termed COV50, is based on 50 specific urinary peptides, all significantly associated with critical/lethal outcome. The most prominent changes observed were reduction of peptides derived from collagen alpha 1(I), polymeric immunoglobulin receptor and CD99 antigen, and an increase in peptides derived from alpha-1antitrypsin 3 . A support-vector machine-based algorithm was applied to combine 50 peptides into a classifier that provides a dimensionless variable predicting outcome.…”