Non-invasive assessment of endothelial dysfunction: A novel method to predict severe COVID-19?

Abstract

The COVID-19 pandemic caused by the SARS-CoV-2 virus has infected millions and overburdened the healthcare infrastructure globally. Recent studies show that the endothelial dysfunction caused by the virus contributes to its high morbidity and mortality. A parameter that can identify patients who will develop complications early will be valuable in patient management and reducing the burden on medical resources. An emerging technology is currently being tested to predict the cardiovascular risk via non-invasively measuring the endothelial dysfunction. This paper reviews how the assessment of endothelial dysfunction using this technology can be used as a potential parameter in the prognostication and management of COVID-19 patients.

Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19

“…Regarding the first assumption, it should be emphasized that bFMD measurement is a non-invasive and easy bedside procedure that provides a result in real time [45]. Therefore, the measurement of bFMD in COVID-19 patients at hospital admission might refine our prognostic ability and possibly improve decision-making about medical care intensity [14]. In this regard, as several drugs against severe COVID-19 are currently under investigation and being tested in clinical trials, the measurement of bFMD upon hospital admission may provide an option to select patients who might benefit from a more intensive treatment approach based on experimental drugs beyond the standard of care.…”

“…In the light of these lines of evidence, great interest has arisen in the search for markers of endothelial injury with potential clinical utility for the stratification of COVID-19 prognosis [12,14]. To date, several cross-sectional, retrospective, and prospective studies have reported significant discriminatory value of some laboratory markers of endothelial dysfunction and damage (e.g., circulating endothelial cells, soluble Intercellular Adhesion Molecule 1, and von Willebrand Factor Antigen) toward COVID-19 severity and clinical outcomes [15][16][17][18].…”

Is There a Relationship between Endotheline-1, Vascular Cell Adhesion Molecule-1 and the Arterial Hypotension Observed during Spinal Anesthesia?

“…Endothelial dysfunction is characterized by a modification of the balance between vasodilator, anti-mitotic, anti-thrombogenic and anti-adhesive substances, in favor of those known as vasoconstrictors, pro thrombogenes, pro adhesives and proliferatives [7] [8] [9] [19]. Despite the controversies regarding their lower sensitivity compared to non-invasive methods [19] [25] [30] [33] [34] [36]- [42], the choice of ET-1 and VCAM-1 as markers of endothelial dysfunction is due to makes their sensitivities and specificities identical to those of other biomarkers of ED [19]- [25] [30] [33] [34] [36] [40] [41] [42]. Regarding the fact that their dosage is not carried out routinely and therefore without reference values, the recruitment of people free from any pathology made it possible to obtain a control value for these two markers.…”

Endothel, vaskuläre Funktion und COVID-19

“…Yoganandamoorthy u. Mitarb. [61] plädieren für ebenfalls nicht invasive Messmethoden der vaskulären Funktion bei COVID-19-Patienten, wie dem Verlust der dikroten Welle in der Druckpulskurve oder einem geringeren Temperaturanstieg im Rahmen einer reaktiven Hyperämie nach suprasystolischer Okklusion der Armarterien [61].…”