Key result
Elevated markers of endothelial injury (angiopoietin-2, follistatin, PAI-1) were strongly predictive of in-hospital mortality in patients with COVID-19.
Why the study?
Endotheliopathy is thought to be key in COVID-19-associated coagulopathy, but prognostic markers indicative of this process and disease severity have not been well-established.
Observational
Distinct mechanisms involving endothelial cell function drive non-critical and critical phases of COVID-19, with endothelial injury markers serving as strong predictors of in-hospital mortality.
Answers are grounded in this paper and cite their sources.
Endothelial markers may refine COVID-19 risk assessment; leaves open targeted interventions for angiogenic versus injury phenotypes.
Increase in thrombotic and microvascular complications is emerging to be a key feature of patients with critical illness associated with COVID-19 infection. While endotheliopathy is thought to be a key factor of COVID-19-associated coagulopathy, markers indicative of this process that are prognostic of disease severity have not been well-established in this patient population. Using plasma profiling of patients with COVID-19, we identified circulating markers that segregated with disease severity: markers of angiogenesis (VEGF-A, PDGF-AA and PDGF-AB/BB) were elevated in hospitalized patients with non-critical COVID-19 infection, while markers of endothelial injury (angiopoietin-2, FLT-3L, PAI-1) were elevated in patients with critical COVID-19 infection. In survival analysis, elevated markers of endothelial injury (angiopoietin-2, follistatin, PAI-1) were strongly predictive of in-hospital mortality. Our findings demonstrate that non-critical and critical phases of COVID-19 disease may be driven by distinct mechanisms involving key aspects of endothelial cell function, and identify drivers of COVID-19 pathogenesis and potential targets for future therapies.
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Pine et al. (2020) conducted an observational in COVID-19. Elevated markers of endothelial injury (angiopoietin-2, follistatin, PAI-1) was evaluated on Disease severity and in-hospital mortality. Elevated markers of endothelial injury (angiopoietin-2, follistatin, PAI-1) were strongly predictive of in-hospital mortality in patients with COVID-19.
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