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Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients.
- Source :
-
Angiogenesis [Angiogenesis] 2020 Nov; Vol. 23 (4), pp. 611-620. Date of Electronic Publication: 2020 May 27. - Publication Year :
- 2020
-
Abstract
- Background: Coronavirus disease-2019 (COVID-19), a respiratory disease has been associated with ischemic complications, coagulation disorders, and an endotheliitis.<br />Objectives: To explore endothelial damage and activation-related biomarkers in COVID-19 patients with criteria of hospitalization for referral to intensive care unit (ICU) and/or respiratory worsening.<br />Methods: Analysis of endothelial and angiogenic soluble markers in plasma from patients at admission.<br />Results: Study enrolled 40 consecutive COVID-19 patients admitted to emergency department that fulfilled criteria for hospitalization. Half of them were admitted in conventional wards without any ICU transfer during hospitalization; whereas the 20 others were directly transferred to ICU. Patients transferred in ICU were more likely to have lymphopenia, decreased SpO2 and increased D-dimer, CRP and creatinine levels. In those patients, soluble E-selectin and angiopoietin-2 were significantly increased (p value at 0.009 and 0.003, respectively). Increase in SELE gene expression (gene coding for E-selectin protein) was confirmed in an independent cohort of 32 patients using a whole blood gene expression profile analysis. In plasma, we found a strong association between angiopoetin-2 and CRP, creatinine and D-dimers (with p value at 0.001, 0.001 and 0.003, respectively). ROC curve analysis identified an Angiopoietin-2 cut-off of 5000 pg/mL as the best predictor for ICU outcome (Se = 80.1%, Sp = 70%, PPV = 72.7%, NPV = 77%), further confirmed in multivariate analysis after adjustment for creatinine, CRP or D-dimers.<br />Conclusion: Angiopoietin-2 is a relevant predictive factor for ICU direct admission in COVID-19 patients. This result showing an endothelial activation reinforces the hypothesis of a COVID-19-associated microvascular dysfunction.
- Subjects :
- Aged
Betacoronavirus
Biomarkers blood
COVID-19
Critical Care methods
E-Selectin blood
Female
Gene Expression Profiling
Hospitalization
Humans
Male
Middle Aged
Pandemics
Patient Admission
Prospective Studies
Respiration, Artificial
SARS-CoV-2
Angiopoietin-2 blood
Coronavirus Infections blood
Coronavirus Infections therapy
Endothelium, Vascular metabolism
Intensive Care Units
Pneumonia, Viral blood
Pneumonia, Viral therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7209
- Volume :
- 23
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Angiogenesis
- Publication Type :
- Academic Journal
- Accession number :
- 32458111
- Full Text :
- https://doi.org/10.1007/s10456-020-09730-0