Open AccessEndothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation – A prospective observational pilot study
Author(s) -
David Astapenko,
Adéla Tomášová,
Alena Tichá,
Radomı́r Hyšpler,
Huey Shin Chua,
Mubashar Manzoor,
Roman Škulec,
Christian Lehmann,
Robert Hahn,
Manu Malbrain,
V. Černý
Publication year - 2022
Publication title -
clinical hemorheology and microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 54
eISSN - 1875-8622
pISSN - 1386-0291
DOI - 10.3233/ch-221401
Subject(s) - medicine , glycocalyx , pneumonia , mechanical ventilation , intensive care unit , endothelial activation , microcirculation , gastroenterology , endothelial dysfunction , coagulopathy , immunology , endothelium
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.