Endothelial injury in COVID-19 and septic patients

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Hokama, Larissa Tami ; Muller Veiga, Alicia Dudy ; Saad Menezes, Maria Clara ; Sardinha Pinto, Agnes Araujo ; de Lima, Thais Martins ; Kubo Ariga, Suely Kunimi ; Barbeiro, Hermes Vieira ; Barbeiro, Denise Frediani ; Moreira, Claudia de Lucena ; Stanzani, Gabriela ; Brandao, Rodrigo Antonio ; Marchini, Julio Flavio ; Alencar, Julio Cesar ; Marino, Lucas Oliveira ; Gomez, Luz Marina ; Souza, Heraldo P. ; Emergency Usp COVID-19 Grp

• Document type: Journal article
• Source: MICROVASCULAR RESEARCH; v. 140, p. 5-pg., 2022-03-01.

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-gamma, TNF-alpha, 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-alpha, 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-gamma 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. (AU)

• FAPESP's process: 20/04738-8 - Patients with Severe Acute Respiratory Syndrome due to COVID-19 in an emergency department
• Grantee: Heraldo Possolo de Souza
• Support Opportunities: Regular Research Grants