Serum VEGF-A and sVEGFR-1 levels as predictors of disease severity in COVID-19 patients

Abstract

Background: The pathogenesis of COVID-19 highlights the pivotal role of endothelial dysfunction and dysregulated angiogenic signaling. Vascular endothelial growth factor A (VEGF-A) and its soluble receptor (sVEGFR-1) are critical regulators of vascular integrity. This study aimed to investigate the association between serum VEGF-A and sVEGFR-1 levels and disease severity in patients diagnosed with COVID-19.

Methods: In this single-center observational study, 92 COVID-19 patients, classified into mild, moderate, and severe categories, and 29 healthy controls were enrolled. Serum VEGF-A and sVEGFR-1 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Clinical, demographic, and laboratory data were collected. Statistical analyses included ANOVA, Kruskal-Wallis, Spearman correlation, logistic regression, and ROC curve analysis.

Results: Both VEGF-A and sVEGFR-1 levels were significantly lower in severe COVID-19 patients compared to controls (p < 0.001). Negative correlations were observed between VEGF-A levels and disease severity (r = -0.55, p < 0.001), and between sVEGFR-1 levels and severity (r = -0.48, p < 0.001). Logistic regression analysis identified VEGF-A as an independent predictor of severe COVID-19 (OR = 0.964, p = 0.021). No significant differences in VEGF-A or sVEGFR-1 levels were found between survivors and non-survivors among the severe group.

Conclusion: Serum VEGF-A and sVEGFR-1 levels are inversely associated with COVID-19 disease severity, suggesting their potential role as early prognostic biomarkers. These findings underscore the importance of endothelial dysfunction in COVID-19 progression and encourage further research on angiogenic markers in viral infections.

Keywords: Biomarkers; COVID-19; Disease severity; Endothelial dysfunction; VEGF-A; sVEGFR-1.