Endothelial injury in COVID-19 and septic patients

Microvasc Res. 2022 Mar:140:104303. doi: 10.1016/j.mvr.2021.104303. Epub 2021 Dec 13.

Abstract

Systemic inflammatory response, as observed in sepsis and severe COVID-19, may lead to endothelial damage. Therefore, we aim to compare the extent of endothelial injury and its relationship to inflammation in both diseases. We included patients diagnosed with sepsis (SEPSIS group, n = 21), mild COVID-19 (MILD group, n = 31), and severe COVID-19 (SEVERE group, n = 24). Clinical and routine laboratory data were obtained, circulating cytokines (INF-γ, TNF-α, and IL-10) and endothelial injury markers (E-Selectin, Tissue Factor (TF) and von Willebrand factor (vWF)) were measured. Compared to the SEPSIS group, patients with severe COVID-19 present similar clinical and laboratory data, except for lower circulating IL-10 and E-Selectin levels. Compared to the MILD group, patients in the SEVERE group showed higher levels of TNF-α, IL-10, and TF. There was no clear relationship between cytokines and endothelial injury markers among the three studied groups; however, in SEVERE COVID-19 patients, there is a positive relationship between INF-γ with TF and a negative relationship between IL-10 and vWF. In conclusion, COVID-19 and septic patients have a similar pattern of cytokines and endothelial dysfunction markers. These findings highlight the importance of endothelium dysfunction in COVID-19 and suggest that endothelium should be better evaluated as a therapeutic target for the disease.

Keywords: Cytokines; E-Selectin; Systematic inflammation; Tissue Factor; von Willebrand Factor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Blood Cell Count
  • C-Reactive Protein / analysis
  • COVID-19 / blood
  • COVID-19 / complications
  • COVID-19 / pathology*
  • COVID-19 / physiopathology
  • E-Selectin / blood
  • Endothelium, Vascular / pathology*
  • Female
  • Humans
  • Interferon-gamma / blood
  • Interleukin-10 / blood
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2*
  • Sepsis / blood
  • Sepsis / complications
  • Sepsis / pathology*
  • Sepsis / physiopathology
  • Severity of Illness Index
  • Systemic Inflammatory Response Syndrome / blood*
  • Systemic Inflammatory Response Syndrome / etiology
  • Systemic Inflammatory Response Syndrome / physiopathology
  • Thromboplastin / analysis
  • Tumor Necrosis Factor-alpha / analysis
  • von Willebrand Factor / analysis

Substances

  • Biomarkers
  • E-Selectin
  • IL10 protein, human
  • SELE protein, human
  • Tumor Necrosis Factor-alpha
  • von Willebrand Factor
  • Interleukin-10
  • Interferon-gamma
  • C-Reactive Protein
  • Thromboplastin