ICU Admission Levels of Endothelial Biomarkers as Predictors of Mortality in Critically Ill COVID-19 Patients

Vassiliou, Alice G.; Keskinidou, Chrysi; Jahaj, Edison; Gallos, Parisis; Dimopoulou, Ioanna; Κοτανίδου, Αναστασία; Orfanos, Stylianos E.

doi:10.3390/cells10010186

Cited by 91 publications

(141 citation statements)

References 43 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…In their study, Spadaro et al found no statistically significant differences between survivor and non-survivor patient groups in terms of sP-Selectin level in 31 patients followed up with mechanical ventilation [ 20 ]. Unlike this study, Vasiliou et al found the sP-Selectin level to be higher in non-survivor critically ill patients than in the survivor patient population [ 21 ].…”

Section: Discussioncontrasting

confidence: 75%

“…In a study conducted by Goshua et al, the levels of markers that play a role in endothelial cell and platelet activation in COVID-19 infection were examined, and the sP-Selectin level was detected to be higher in patients treated in the intensive care unit compared to patients who did not require intensive care [ 18 ]. More recently, other studies have examined the level of sP-Selectin in severe and non-severe COVID-19 patient groups as well as the sP-Selectin levels and clinical diagnostic values in critically ill patients in survivor and non-survivor groups [ [19] , [20] , [21] ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

et al. 2021

View full text Add to dashboard Cite

Introduction To our knowledge, the diagnostic value of the sP-Selectin level in the diagnosis of COVID-19 disease has not yet been investigated. In this study, we aimed to assess this by evaluating the relationship between sP-Selectin level and the clinical severity of COVID-19 infections. Methods A total of 80 patients (50 with mild to moderate and 30 with severe COVID-19 pneumonia), and 60 non-symptomatic healthy volunteers participated in the study. Following serum isolation, sP-Selectin levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA) method. Results The serum sP-Selectin level was 1.7 ng/ml in the control group (1–3.78); 6.24 ng/ml (5.14–7.23) in mild-to-moderate pneumonia group; and 6.72 ng/ml (5.36–8.03) in the severe pneumonia group. Serum sP-Selectin levels in both mild-to-moderate pneumonia and severe pneumonia groups were found to be higher than the control group, with statistical significance ( p = 0.0001 and p = 0.0001, respectively). Receiver operating characteristic analysis (ROC) showed greater area under the curve (AUC) for the serum sP-Selectin levels of the COVID-19 patients (AUC = 0.913, 95% CI = 0.857–0.969; p = 0.0001). The serum sP-Selectin level was found to be 97.5% sensitive and 80% specific at 4.125 ng/ml level for diagnosis (p = 0.0001). The serum sP-Selectin level was found to be 76.9% sensitive and 51.9% specific at the level of 6.12 ng/ml ( p = 0.005) to predict the need for intensive care treatment. Conclusion This study showed that sP-Selectin can be used as a valuable biomarker in both diagnosing and predicting the need for intensive care treatment of COVID-19 infection.

show abstract

Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Specifically, a threshold of 423% of VWF (normal values: 50–150%) offered an optimal sensitivity–specificity balance [ 114 ]. Both Vassiliou et al and von Meijenfeldt et al confirmed this observation by reporting from cohorts of, respectively, 38 ICU and 102 mixed-severity COVID-19 patients, a significantly higher level of VWF factor at admission in non-survivors than in survivors [ 95 , 115 ].…”

Section: Covid-19 Is An Endothelial Diseasementioning

confidence: 93%

“…In patients on mechanical ventilation, angiopoietin-2 correlated inversely with pulmonary compliance, a measure of the lung's ability to stretch and expand [ 94 ]. Another group determined angiopoietin-2 levels on ICU admission in 38 COVID-19 patients, most of whom were mechanically ventilated [ 95 ]. Angiopoietin-2 was significantly higher in non-survivors ( n = 10) and a quite similar cut-off of 4.0 ng/mL predicted ICU mortality with a sensitivity of 89% and a specificity of 77%.…”

Section: Covid-19 Is An Endothelial Diseasementioning

confidence: 99%

“…Especially VCAM-1 but also ICAM-1 levels correlated with SARS-CoV-2 RNAemia [ 97 ]. Orfanos et al found that soluble E-selectin and soluble ICAM-1 correlated with disease severity and predicted ICU mortality in 38 critically ill COVID-19 patients [ 95 ]. Similarly, serum levels of soluble platelet endothelial adhesion molecule (sPECAM-1) were elevated and correlated with disease severity in COVID-19 patients ( n = 38), whereas asymptomatic carriers had similar sPECAM-1 levels as healthy controls [ 110 ].…”

Section: Covid-19 Is An Endothelial Diseasementioning

confidence: 99%

See 1 more Smart Citation

COVID-19 is a systemic vascular hemopathy: insight for mechanistic and clinical aspects

et al. 2021

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is presenting as a systemic disease associated with vascular inflammation and endothelial injury. Severe forms of SARS-CoV-2 infection induce acute respiratory distress syndrome (ARDS) and there is still an ongoing debate on whether COVID-19 ARDS and its perfusion defect differs from ARDS induced by other causes. Beside pro-inflammatory cytokines (such as interleukin-1 β [IL-1β] or IL-6), several main pathological phenomena have been seen because of endothelial cell (EC) dysfunction: hypercoagulation reflected by fibrin degradation products called D-dimers, micro- and macrothrombosis and pathological angiogenesis. Direct endothelial infection by SARS-CoV-2 is not likely to occur and ACE-2 expression by EC is a matter of debate. Indeed, endothelial damage reported in severely ill patients with COVID-19 could be more likely secondary to infection of neighboring cells and/or a consequence of inflammation. Endotheliopathy could give rise to hypercoagulation by alteration in the levels of different factors such as von Willebrand factor. Other than thrombotic events, pathological angiogenesis is among the recent findings. Overexpression of different proangiogenic factors such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor (FGF-2) or placental growth factors (PlGF) have been found in plasma or lung biopsies of COVID-19 patients. Finally, SARS-CoV-2 infection induces an emergency myelopoiesis associated to deregulated immunity and mobilization of endothelial progenitor cells, leading to features of acquired hematological malignancies or cardiovascular disease, which are discussed in this review. Altogether, this review will try to elucidate the pathophysiology of thrombotic complications, pathological angiogenesis and EC dysfunction, allowing better insight in new targets and antithrombotic protocols to better address vascular system dysfunction. Since treating SARS-CoV-2 infection and its potential long-term effects involves targeting the vascular compartment and/or mobilization of immature immune cells, we propose to define COVID-19 and its complications as a systemic vascular acquired hemopathy.

show abstract

Biomarkers of endothelial dysfunction are associated with poor outcome in COVID‐19 patients: A systematic review and meta‐analysis

Mohebbi

Haybar

Moghaddam

et al. 2023

Reviews in Medical Virology

View full text Add to dashboard Cite

Numerous studies have linked coronavirus disease 2019 (COVID‐19) with endothelial dysfunction and reported elevated levels of endothelial biomarkers in this disease. We conducted a systematic review and meta‐analysis of the published evidence in this respect. A systematic literature search of PubMed and Scopus databases was performed to find studies investigating biomarkers of endothelial dysfunction in COVID‐19 patients. Pooled standardized mean differences and their 95% confidence intervals were calculated for each biomarker using random effect model. 74 studies with 7668 patients were included. In comparison to patients with good outcome, those with poor outcome had higher levels of von Willebrand factor (vWF) (SMD: 0.83, 95% CI: 0.59–1.07, p < 0.00001), vWF:ADAMTS13 (1.23, (0.77–1.7), p < 0.00001), angiopoietin‐2 (Ang‐2) (1.06 (0.6–1.51), p < 0.0001), E‐selectin (1.09 (0.55–1.63), p < 0.0001), P‐selectin (0.59 (0.24–0.94), p = 0.001), syndecan‐1 (0.99 (0.6–1.37), p < 0.00001), mid‐regional pro‐adrenomedullin (MR‐proADM) (1.52 (1.35–1.68), p < 0.00001), vascular endothelial growth factor (0.27 (0.02–0.53), p = 0.03), soluble fms‐like tyrosine kinase‐1 (sFLT‐1) (1.93 (0.65–3.21), p = 0.03) and lower levels of ADAMTS13 antigen (−0.69 (−0.9 to −0.47) p < 0.00001) and activity (−0.84 (−1.06 to −0.61) p < 0.0000). Plasminogen activator inhibitor‐1 and tissue plasminogen activator levels were not different between the two groups (p < 0.05). There were elevated levels of endothelial dysfunction biomarkers in COVID‐19 patients with poor outcome, indicating their possible role in disease severity and prognosis. In particular, MR‐proADM, vWF, syndecan‐1 and sFLT‐1 showed a significant association with poor outcome in these patients.

show abstract

ICU Admission Levels of Endothelial Biomarkers as Predictors of Mortality in Critically Ill COVID-19 Patients

Cited by 91 publications

References 43 publications

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

Soluble P-selectin as a potential diagnostic and prognostic biomarker for COVID-19 disease: A case-control study

COVID-19 is a systemic vascular hemopathy: insight for mechanistic and clinical aspects

Biomarkers of endothelial dysfunction are associated with poor outcome in COVID‐19 patients: A systematic review and meta‐analysis

Contact Info

Product

Resources

About