tetano
Editor, Senior Moderator
Clin Hemorheol Microcirc
. 2022 Mar 21.
doi: 10.3233/CH-221401. Online ahead of print.
Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation - a prospective observational pilot study
David Astapenko[SUP] 1 2 3 [/SUP], Adela Tomasova[SUP] 2 4 [/SUP], Alena Ticha[SUP] 4 [/SUP], Radomir Hyspler[SUP] 2 4 [/SUP], Huey Shin Chua[SUP] 2 [/SUP], Mubashar Manzoor[SUP] 2 [/SUP], Roman Skulec[SUP] 2 5 [/SUP], Christian Lehmann[SUP] 6 7 8 9 [/SUP], Robert Hahn[SUP] 10 11 [/SUP], Manu Lng Malbrain[SUP] 12 13 14 [/SUP], Vladimir Cerny[SUP] 1 2 3 5 6 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern.
Objective: The objective of the present single-center observational pilot study was to compare endothelial glycocalyx (EG) damage and endotheliopathy in patients with severe COVID-19 (COVID-19 group) with patients with bacterial pneumonia with septic shock (non-COVID group).
Methods: Biomarkers of EG damage (syndecan-1), endothelial cells (EC) damage (thrombomodulin), and activation (P-selectin) were measured in blood on three consecutive days from admission to the intensive care unit (ICU). The sublingual microcirculation was studied by Side-stream Dark Field (SDF) imaging with automatic assessment.
Results: We enrolled 13 patients in the non-COVID group (mean age 70 years, 6 women), and 15 in the COVID-19 group (64 years old, 3 women). The plasma concentrations of syndecan-1 were significantly higher in the COVID-19 group during all three days. Differences regarding other biomarkers were not statistically significant. The assessment of the sublingual microcirculation showed improvement on Day 2 in the COVID-19 group. Plasma levels of C-reactive protein (CRP) were significantly higher on the first two days in the COVID-19 group. Plasma syndecan-1 and CRP were higher in patients suffering from severe COVID-19 pneumonia compared to bacterial pneumonia patients.
Conclusions: These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.
Keywords: glycocalyx; pneumonia; sepsis.
. 2022 Mar 21.
doi: 10.3233/CH-221401. Online ahead of print.
Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation - a prospective observational pilot study
David Astapenko[SUP] 1 2 3 [/SUP], Adela Tomasova[SUP] 2 4 [/SUP], Alena Ticha[SUP] 4 [/SUP], Radomir Hyspler[SUP] 2 4 [/SUP], Huey Shin Chua[SUP] 2 [/SUP], Mubashar Manzoor[SUP] 2 [/SUP], Roman Skulec[SUP] 2 5 [/SUP], Christian Lehmann[SUP] 6 7 8 9 [/SUP], Robert Hahn[SUP] 10 11 [/SUP], Manu Lng Malbrain[SUP] 12 13 14 [/SUP], Vladimir Cerny[SUP] 1 2 3 5 6 [/SUP]
Affiliations
- PMID: 35342082
- DOI: 10.3233/CH-221401
Abstract
Background: Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern.
Objective: The objective of the present single-center observational pilot study was to compare endothelial glycocalyx (EG) damage and endotheliopathy in patients with severe COVID-19 (COVID-19 group) with patients with bacterial pneumonia with septic shock (non-COVID group).
Methods: Biomarkers of EG damage (syndecan-1), endothelial cells (EC) damage (thrombomodulin), and activation (P-selectin) were measured in blood on three consecutive days from admission to the intensive care unit (ICU). The sublingual microcirculation was studied by Side-stream Dark Field (SDF) imaging with automatic assessment.
Results: We enrolled 13 patients in the non-COVID group (mean age 70 years, 6 women), and 15 in the COVID-19 group (64 years old, 3 women). The plasma concentrations of syndecan-1 were significantly higher in the COVID-19 group during all three days. Differences regarding other biomarkers were not statistically significant. The assessment of the sublingual microcirculation showed improvement on Day 2 in the COVID-19 group. Plasma levels of C-reactive protein (CRP) were significantly higher on the first two days in the COVID-19 group. Plasma syndecan-1 and CRP were higher in patients suffering from severe COVID-19 pneumonia compared to bacterial pneumonia patients.
Conclusions: These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.
Keywords: glycocalyx; pneumonia; sepsis.