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• W3212034243 abstract "Background : Endotheliopathy is a key element in COVID-19 pathophysiology, contributing to both morbidity and mortality. Biomarkers distinguishing different COVID-19 phenotypes from sepsis syndromes remain poorly understood. Aims : We aimed to characterize circulating biomarkers of endothelial damage in different COVID-19 clinical disease stages in comparison to sepsis syndromes and normal volunteers. Methods : Patients with COVID-19 pneumonia ( n = 49) were included and classified into moderate, severe or critical (life-threatening). Patients with other septic syndromes: sepsis (S, n = 7), septic shock (SS, n = 14) and patients with non-infectious systemic inflammatory response syndrome (NI-SIRS, n = 7) were also included. Plasma samples were collected within 48-72 h of hospitalization to analyze endothelial activation markers, including sVCAM-1, VWF, ADAMTS-13 activity, thrombomodulin (TM) and soluble TNF receptor I (sTNFRI);heparan sulfate (HS) for endothelial glycocalyx degradation;C5b9 deposits on endothelial cells in culture and soluble C5b9 for complement activation;circulating dsDNA for neutrophil extracellular traps (NETs) presence, and α2-antiplasmin and PAI-1 as parameters of fibrinolysis. Results were compared to healthy donors as controls ( n = 45);all three COVID-19 groups and septic shock patients. Results : All analyzed biomarkers were increased in COVID-19 patients vs. controls ( P < 0.001), except for ADAMTS-13 activity which was normal in both groups. Correlation with disease severity was observed for sVCAM-1, VWF, sTNFRI and HS ( P < 0.05). SS patients showed significantly higher levels of VWF, TM, sTNFRI and NETS, with reduced ADAMTS-13 activity ( P < 0.05). Importantly, α2-antiplasmin activity was higher in critical COVID-19 ( P < 0.001) vs. SS. Conclusions : COVID-19 patients present increased circulating endothelial stress products, complement activation and fibrinolytic dysregulation, associated with disease severity. COVID-19 endotheliopathy differs from SS, in which endothelial damage is also a critical feature of pathobiology. These biomarker profiles may inform therapeutic intervention in COVID-19." @default.
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• W3212034243 date "2021-01-01" @default.
• W3212034243 modified "2023-10-18" @default.
• W3212034243 title "Distinctive biomarker features in the endotheliopathy of COVID-19 and septic syndromes" @default.
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