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. 2024 Jul 4;24(1):325.
doi: 10.1186/s12890-024-03136-0.

Endothelial biomarkers (Von willebrand factor, BDCA3, urokinase) as predictors of mortality in COVID-19 patients: cohort study

Rocío Nayeli Sánchez-Santillán  1 , Martha Patricia Sierra-Vargas  2 , Dulce González-Islas  1 , Octavio Gamaliel Aztatzi-Aguilar  3 , Rogelio Pérez-Padilla  4 , Arturo Orea-Tejeda  5   6 , Yazmín Debray-García  7 , Manolo Ortega-Romero  7 , Candace Keirns-Davis  1 , Alejandra Loaeza-Roman  7 , Alejandra Rios-Pereda  1
Affiliations

Endothelial biomarkers (Von willebrand factor, BDCA3, urokinase) as predictors of mortality in COVID-19 patients: cohort study

Rocío Nayeli Sánchez-Santillán et al. BMC Pulm Med. .

Abstract

Background: SARS-CoV-2 is a systemic disease that affects endothelial function and leads to coagulation disorders, increasing the risk of mortality. Blood levels of endothelial biomarkers such as Von Willebrand Factor (VWF), Thrombomodulin or Blood Dendritic Cell Antigen-3 (BDCA3), and uUokinase (uPA) increase in patients with severe disease and can be prognostic indicators for mortality. Therefore, the aim of this study was to determine the effect of VWF, BDCA3, and uPA levels on mortality.

Methods: From May 2020 to January 2021, we studied a prospective cohort of hospitalized adult patients with polymerase chain reaction (PCR)-confirmed COVID-19 with a SaO2 ≤ 93% and a PaO2/FiO2 ratio < 300. In-hospital survival was evaluated from admission to death or to a maximum of 60 days of follow-up with Kaplan-Meier survival curves and Cox proportional hazard models as independent predictor measures of endothelial dysfunction.

Results: We recruited a total of 165 subjects (73% men) with a median age of 57.3 ± 12.9 years. The most common comorbidities were obesity (39.7%), hypertension (35.4%) and diabetes (30.3%). Endothelial biomarkers were increased in non-survivors compared to survivors. According to the multivariate Cox proportional hazard model, those with an elevated VWF concentration ≥ 4870 pg/ml had a hazard ratio (HR) of 4.06 (95% CI: 1.32-12.5) compared to those with a lower VWF concentration adjusted for age, cerebrovascular events, enoxaparin dose, lactate dehydrogenase (LDH) level, and bilirubin level. uPA and BDCA3 also increased mortality in patients with levels ≥ 460 pg/ml and ≥ 3600 pg/ml, respectively.

Conclusion: The risk of mortality in those with elevated levels of endothelial biomarkers was observable in this study.

Keywords: BDCA3; COVID-19; Endothelial dysfunction; Mortality; SARS-CoV-2; Von Willebrand factor; uPA.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan Meier survival curves for endothelial biomarkers. (1 -A) von Willebrand factor analysis. (1-B) BDCA3 or thrombomodulin analysis. (1-C) uPA or Urokinase analysis. Adjusted model was done for each endothelial factor
See this image and copyright information in PMC

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