Syndecan-1, an indicator of endothelial glycocalyx degradation, predicts outcome of patients admitted to an ICU with COVID-19.

Abstract

BACKGROUND:

We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality.

METHODS:

The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed.

RESULTS:

The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan-Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors.

CONCLUSIONS:

COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19.

• Authors: Dong Zhang, Liubing Li, Yu Chen, Jie Ma, Yanli Yang, Surita Aodeng, Qiuju Cui, Kedi Wen, Meng Xiao, Jing Xie, Yingchun Xu, Yongzhe Li
• Journal: Molecular medicine (Cambridge, Mass.) (Mol Med) Vol. 27 Issue 1 Pg. 151 (12 03 2021) ISSN: 1528-3658 [Electronic] England
• PMID: 34861818 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s).

Chemical References

• Biomarkers
• Cytokines
• IL6 protein, human
• Interleukin-6
• SDC1 protein, human
• Syndecan-1
• THBD protein, human
• TNF protein, human
• Thrombomodulin
• Tumor Necrosis Factor-alpha
• Oxygen

Topics

• Aged
• Biomarkers (blood)
• Blood Coagulation
• COVID-19 (blood, mortality, therapy)
• China (epidemiology)
• Cytokines (metabolism)
• Endothelium (metabolism)
• Endothelium, Vascular (pathology)
• Female
• Glycocalyx (metabolism)
• Humans
• Inflammation
• Intensive Care Units
• Interleukin-6 (blood)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Oxygen
• ROC Curve
• SARS-CoV-2
• Syndecan-1 (blood)
• Thrombomodulin (blood)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (blood)