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Comparative Study
. 2022 Mar:140:104303.
doi: 10.1016/j.mvr.2021.104303. Epub 2021 Dec 13.

Endothelial injury in COVID-19 and septic patients

Larissa Tami Hokama  1 , Alicia Dudy Müller Veiga  2 , Maria Clara Saad Menezes  2 , Agnes Araujo Sardinha Pinto  2 , Thais Martins de Lima  2 , Suely Kunimi Kubo Ariga  2 , Hermes Vieira Barbeiro  2 , Denise Frediani Barbeiro  2 , Claudia de Lucena Moreira  2 , Gabriela Stanzani  2 , Rodrigo Antonio Brandao  2 , Julio Flavio Marchini  2 , Julio Cesar Alencar  2 , Lucas Oliveira Marino  2 , Luz Marina Gomez  2 ; Emergency USP COVID-19 Group  2 ; Heraldo P Souza  2
Affiliations
Comparative Study

Endothelial injury in COVID-19 and septic patients

Larissa Tami Hokama et al. Microvasc Res. 2022 Mar.

Abstract

Systemic inflammatory response, as observed in sepsis and severe COVID-19, may lead to endothelial damage. Therefore, we aim to compare the extent of endothelial injury and its relationship to inflammation in both diseases. We included patients diagnosed with sepsis (SEPSIS group, n = 21), mild COVID-19 (MILD group, n = 31), and severe COVID-19 (SEVERE group, n = 24). Clinical and routine laboratory data were obtained, circulating cytokines (INF-γ, TNF-α, and IL-10) and endothelial injury markers (E-Selectin, Tissue Factor (TF) and von Willebrand factor (vWF)) were measured. Compared to the SEPSIS group, patients with severe COVID-19 present similar clinical and laboratory data, except for lower circulating IL-10 and E-Selectin levels. Compared to the MILD group, patients in the SEVERE group showed higher levels of TNF-α, IL-10, and TF. There was no clear relationship between cytokines and endothelial injury markers among the three studied groups; however, in SEVERE COVID-19 patients, there is a positive relationship between INF-γ with TF and a negative relationship between IL-10 and vWF. In conclusion, COVID-19 and septic patients have a similar pattern of cytokines and endothelial dysfunction markers. These findings highlight the importance of endothelium dysfunction in COVID-19 and suggest that endothelium should be better evaluated as a therapeutic target for the disease.

Keywords: Cytokines; E-Selectin; Systematic inflammation; Tissue Factor; von Willebrand Factor.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Cytokines in Sepsis and SEVERE COVID-19. The cytokines profile was similar in patients who died from sepsis or COVID-19. The only exception was IL-10 (Panel C), which was higher in septic patients.
Fig. 2
Fig. 2
Endothelial dysfunction markers in Sepsis and SEVERE COVID-19. When compared to septic patients, SEVERE COVID-19 patients present lower plasma levels of E-Selectin (Panel B) and similar levels of vWF and TF (Panels A and C).
Fig. 3
Fig. 3
Cytokines in MILD and SEVERE COVID-19. SEVERE COVID-19 patients present higher plasma levels of TNF-α (Panel B), and IL-10 (Panel C) compared to MILD patients. However, other cytokines were not different between these two groups.
Fig. 4
Fig. 4
Endothelial dysfunction markers in MILD and SEVERE COVID-19. Severely ill COVID-19 patients showed higher plasma levels of TF (Panel C) and similar levels of vWF and E-Selectin when compared to MILD COVID-19 patients.
See this image and copyright information in PMC

References

    1. Abebe W., Mozaffari M. Endothelial dysfunction in diabetes: potential application of circulating markers as advanced diagnostic and prognostic tools. EPMA J. 2010;1(1):32–45. (Mar) - PMC - PubMed
    1. Anderson T.J. Assessment and treatment of endothelial dysfunction in humans. J. Am. Coll. Cardiol. 1999;34(3):631–638. (Sep) - PubMed
    1. Andrianto Al-Farabi M.J., Nugraha R.A., Marsudi B.A., Azmi Y. Biomarkers of endothelial dysfunction and outcomes in coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis. Microvasc. Res. 2021;138 (Nov) - PMC - PubMed
    1. Del Valle D.M., Kim-Schulze S., Huang H.-H., Beckmann N.D., Nirenberg S., Wang B., et al. An inflammatory cytokine signature predicts COVID-19 severity and survival. Nat. Med. 2020;26(10):1636–1643. - PMC - PubMed
    1. Ince C., Mayeux P.R., Nguyen T., Gomez H., Kellum J.A., Ospina-Tascón G.A., et al. The endothelium in sepsis. Shock. 2016;45(3):259–270. (Mar) - PMC - PubMed

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