Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation - A prospective observational pilot study.


Journal

Clinical hemorheology and microcirculation
ISSN: 1875-8622
Titre abrégé: Clin Hemorheol Microcirc
Pays: Netherlands
ID NLM: 9709206

Informations de publication

Date de publication:
2022
Historique:
pubmed: 29 3 2022
medline: 15 6 2022
entrez: 28 3 2022
Statut: ppublish

Résumé

Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern. 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). 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. 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. These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.

Sections du résumé

BACKGROUND BACKGROUND
Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern.
OBJECTIVE 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 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 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 CONCLUSIONS
These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.

Identifiants

pubmed: 35342082
pii: CH221401
doi: 10.3233/CH-221401
doi:

Substances chimiques

Biomarkers 0
Syndecan-1 0

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

205-219

Auteurs

David Astapenko (D)

Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Center for Research and Development, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Adela Tomasova (A)

Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Alena Ticha (A)

Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Radomir Hyspler (R)

Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Huey Shin Chua (HS)

Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.

Mubashar Manzoor (M)

Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.

Roman Skulec (R)

Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Department of Anesthesiology, Perioperative Medicine, and Intensive Care, J.E. Purkinje University, Masaryk Hospital, Usti nad Labem, Czech Republic.

Christian Lehmann (C)

Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada.
Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
Department of Physiology and Biophysics, Dalhousie University, Halifax, NS, Canada.

Robert G Hahn (RG)

Research Unit, Södertälje Hospital, Södertälje, Sweden.
Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden.

Manu Lng Malbrain (ML)

First Department of Anaesthesia and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
International Fluid Academy, Lovenjoel, Belgium.

Vladimir Cerny (V)

Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Center for Research and Development, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Department of Anesthesiology, Perioperative Medicine, and Intensive Care, J.E. Purkinje University, Masaryk Hospital, Usti nad Labem, Czech Republic.
Department of Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.

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Classifications MeSH