tetano
Editor, Senior Moderator
Respir Res
. 2021 May 13;22(1):148.
doi: 10.1186/s12931-021-01742-8.
Association of endothelial activation assessed through endothelin-I precursor peptide measurement with mortality in COVID-19 patients: an observational analysis
Claudia Gregoriano[SUP] #[/SUP][SUP] 1 [/SUP], Dominik Damm[SUP] #[/SUP][SUP] 2 [/SUP], Alexander Kutz[SUP] 2 [/SUP], Daniel Koch[SUP] 2 [/SUP], Selina Wolfisberg[SUP] 2 [/SUP], Sebastian Haubitz[SUP] 2 3 [/SUP], Anna Conen[SUP] 4 3 [/SUP], Luca Bernasconi[SUP] 5 [/SUP], Angelika Hammerer-Lercher[SUP] 5 [/SUP], Christoph A Fux[SUP] 2 3 [/SUP], Beat Mueller[SUP] 2 4 [/SUP], Philipp Schuetz[SUP] 2 4 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has been linked to thrombotic complications and endothelial dysfunction. We assessed the prognostic implications of endothelial activation through measurement of endothelin-I precursor peptide (proET-1), the stable precursor protein of Endothelin-1, in a well-defined cohort of patients hospitalized with COVID-19.
Methods: We measured proET-1 in 74 consecutively admitted adult patients with confirmed COVID-19 and compared its prognostic accuracy to that of patients with community-acquired pneumonia (n = 876) and viral bronchitis (n = 371) from a previous study by means of logistic regression analysis. The primary endpoint was all-cause 30-day mortality.
Results: Overall, median admission proET-1 levels were lower in COVID-19 patients compared to those with pneumonia and exacerbated bronchitis, respectively (57.0 pmol/l vs. 113.0 pmol/l vs. 96.0 pmol/l, p < 0.01). Although COVID-19 non-survivors had 1.5-fold higher admission proET-1 levels compared to survivors (81.8 pmol/l [IQR: 76 to 118] vs. 53.6 [IQR: 37 to 69]), no significant association of proET-1 levels and mortality was found in a regression model adjusted for age, gender, creatinine level, diastolic blood pressure as well as cancer and coronary artery disease (adjusted OR 0.1, 95% CI 0.0009 to 14.7). In patients with pneumonia (adjusted OR 25.4, 95% CI 5.1 to 127.4) and exacerbated bronchitis (adjusted OR 120.1, 95% CI 1.9 to 7499) we found significant associations of proET-1 and mortality.
Conclusions: Compared to other types of pulmonary infection, COVID-19 shows only a mild activation of the endothelium as assessed through measurement of proET-1. Therefore, the high mortality associated with COVID-19 may not be attributed to endothelial dysfunction by the surrogate marker proET-1.
Keywords: All-cause 30-day mortality; COVID-19; Endothelin-1; ProET-1; Prognostic marker; Risk assessment; SARS-CoV-2.
. 2021 May 13;22(1):148.
doi: 10.1186/s12931-021-01742-8.
Association of endothelial activation assessed through endothelin-I precursor peptide measurement with mortality in COVID-19 patients: an observational analysis
Claudia Gregoriano[SUP] #[/SUP][SUP] 1 [/SUP], Dominik Damm[SUP] #[/SUP][SUP] 2 [/SUP], Alexander Kutz[SUP] 2 [/SUP], Daniel Koch[SUP] 2 [/SUP], Selina Wolfisberg[SUP] 2 [/SUP], Sebastian Haubitz[SUP] 2 3 [/SUP], Anna Conen[SUP] 4 3 [/SUP], Luca Bernasconi[SUP] 5 [/SUP], Angelika Hammerer-Lercher[SUP] 5 [/SUP], Christoph A Fux[SUP] 2 3 [/SUP], Beat Mueller[SUP] 2 4 [/SUP], Philipp Schuetz[SUP] 2 4 [/SUP]
Affiliations
- PMID: 33985491
- DOI: 10.1186/s12931-021-01742-8
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has been linked to thrombotic complications and endothelial dysfunction. We assessed the prognostic implications of endothelial activation through measurement of endothelin-I precursor peptide (proET-1), the stable precursor protein of Endothelin-1, in a well-defined cohort of patients hospitalized with COVID-19.
Methods: We measured proET-1 in 74 consecutively admitted adult patients with confirmed COVID-19 and compared its prognostic accuracy to that of patients with community-acquired pneumonia (n = 876) and viral bronchitis (n = 371) from a previous study by means of logistic regression analysis. The primary endpoint was all-cause 30-day mortality.
Results: Overall, median admission proET-1 levels were lower in COVID-19 patients compared to those with pneumonia and exacerbated bronchitis, respectively (57.0 pmol/l vs. 113.0 pmol/l vs. 96.0 pmol/l, p < 0.01). Although COVID-19 non-survivors had 1.5-fold higher admission proET-1 levels compared to survivors (81.8 pmol/l [IQR: 76 to 118] vs. 53.6 [IQR: 37 to 69]), no significant association of proET-1 levels and mortality was found in a regression model adjusted for age, gender, creatinine level, diastolic blood pressure as well as cancer and coronary artery disease (adjusted OR 0.1, 95% CI 0.0009 to 14.7). In patients with pneumonia (adjusted OR 25.4, 95% CI 5.1 to 127.4) and exacerbated bronchitis (adjusted OR 120.1, 95% CI 1.9 to 7499) we found significant associations of proET-1 and mortality.
Conclusions: Compared to other types of pulmonary infection, COVID-19 shows only a mild activation of the endothelium as assessed through measurement of proET-1. Therefore, the high mortality associated with COVID-19 may not be attributed to endothelial dysfunction by the surrogate marker proET-1.
Keywords: All-cause 30-day mortality; COVID-19; Endothelin-1; ProET-1; Prognostic marker; Risk assessment; SARS-CoV-2.