Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation-A prospective observational pilot study

David Astapenko, Adela Tomasova, Alena Ticha, Radomir Hyspler, Huey Shin Chua, Mubashar Manzoor, Roman Skulec, Christian Lehmann, Robert G. Hahn, Manu L.N.G. Malbrain, Vladimir Cerny

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

BACKGROUND: Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern. OBJECTIVE: The objective of the present single-center observational pilot study was to compare endothelial glycocalyx (EG) damage and endotheliopathy in patients with severe COVID-19 (COVID-19 group) with patients with bacterial pneumonia with septic shock (non-COVID group). METHODS: Biomarkers of EG damage (syndecan-1), endothelial cells (EC) damage (thrombomodulin), and activation (P-selectin) were measured in blood on three consecutive days from admission to the intensive care unit (ICU). The sublingual microcirculation was studied by Side-stream Dark Field (SDF) imaging with automatic assessment. RESULTS: We enrolled 13 patients in the non-COVID group (mean age 70 years, 6 women), and 15 in the COVID-19 group (64 years old, 3 women). The plasma concentrations of syndecan-1 were significantly higher in the COVID-19 group during all three days. Differences regarding other biomarkers were not statistically significant. The assessment of the sublingual microcirculation showed improvement on Day 2 in the COVID-19 group. Plasma levels of C-reactive protein (CRP) were significantly higher on the first two days in the COVID-19 group. Plasma syndecan-1 and CRP were higher in patients suffering from severe COVID-19 pneumonia compared to bacterial pneumonia patients. CONCLUSIONS: These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.

Original languageEnglish
Pages (from-to)205-219
Number of pages15
JournalClinical Hemorheology and Microcirculation
Volume81
Issue number3
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022-IOS Press. All rights reserved.

ASJC Scopus Subject Areas

  • Physiology
  • Hematology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

PubMed: MeSH publication types

  • Journal Article
  • Observational Study

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