New laboratory evidence for the association between endothelial dysfunction and COVID-19 disease progression.

Abstract

There is growing evidence that angiotensin-converting enzyme 2 is highly expressed on endothelial cells, endothelial dysfunction plays a critical role in coronavirus disease 2019 (COVID-19) progression, but laboratory evidence is still lacking. This study established a multicenter retrospective cohort of 966 COVID-19 patients from three hospitals in Wuhan, China. We found that male (62.8% vs. 46.5%), old age [72 (17) vs. 60.5 (21)], and coexisting chronic diseases (88.5% vs. 60.0%) were associated with poor clinical prognosis in COVID-19. Furthermore, the deteriorated patients exhibited more severe multiorgan damage, coagulation dysfunction, and extensive inflammation. Additionally, a cross-sectional study including 41 non-COVID-19 controls and 39 COVID-19 patients assayed endothelial function parameters in plasma and showed that COVID-19 patients exhibited elevated vascular cell adhesion molecule-1 (VCAM-1) (median [IQR]: 0.32 [0.27] vs. 0.17 [0.11] μg/ml, p < 0.001), E-selectin (21.06 [12.60] vs. 11.01 [4.63] ng/ml, p < 0.001), tissue-type plasminogen activator (tPA) (0.22 [0.12] vs. 0.09 [0.04] ng/ml, p < 0.001), and decreased plasminogen activator inhibitor-1 (0.75 [1.31] vs 6.20 [5.34] ng/ml, p < 0.001), as compared to normal controls. Moreover, VCAM-1 was positively correlated with d-dimer (R = 0.544, p < 0.001); tPA was positively correlated with d-dimer (R = 0.800, p < 0.001) and blood urea nitrogen (R = 0.638, p < 0.001). Our findings further confirm the strong association between endothelial dysfunction and poor prognosis of COVID-19, which offers a rationale for targeting endothelial dysfunction as a therapeutic strategy for COVID-19.

• Authors: Nan Liu, Hui Long, Jianhua Sun, Huan Li, Yunting He, Qiang Wang, Kai Pan, Yongliang Tong, Bingshun Wang, Qingming Wu, Likun Gong
• Journal: Journal of medical virology (J Med Virol) Vol. 94 Issue 7 Pg. 3112-3120 (07 2022) ISSN: 1096-9071 [Electronic] United States
• PMID: 35246853 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2022 Wiley Periodicals LLC.

Chemical References

• Biomarkers
• Vascular Cell Adhesion Molecule-1

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers
• COVID-19 (complications, diagnosis)
• Cross-Sectional Studies
• Disease Progression
• Endothelial Cells
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Vascular Cell Adhesion Molecule-1
• Vascular Diseases (virology)