Comparison of host endothelial, epithelial and inflammatory response in ICU patients with and without COVID-19: a prospective observational cohort study

Comparison of host endothelial, epithelial and inflammatory response in ICU patients with and without COVID-19: a prospective observational cohort study

Pavan K. Bhatraju, Eric D. Morrell, Xin-Ya Chai, Mark M. Wurfel, T. Eoin West, Leila Zelnick, Neha A. Sathe, Sana S. Sakr, Sharon K. Sahi, Anthony Sader, Dawn M. Lum, Ted Liu, Neall Koetje, Ashley Garay, Elizabeth Barnes, Jonathan Lawson, Gail Cromer, Mary K. Bray, Sudhakar Pipavath, Bryan R. Kestenbaum, W. Conrad Liles, Susan L. Fink, Laura Evans, Carmen Mikacenic

Abstract Background Analyses of blood biomarkers involved in the host response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection can reveal distinct biological pathways and inform development and testing of therapeutics for COVID-19. Our objective was to evaluate host endothelial, epithelial and inflammatory biomarkers in COVID-19. Methods We prospectively enrolled 171 ICU patients, including 78 (46%) patients positive and 93 (54%) negative for SARS-CoV-2 infection from April to September, 2020. We compared 22 plasma biomarkers in blood collected within 24 h and 3 days after ICU admission. Results In critically ill COVID-19 and non-COVID-19 patients, the most common ICU admission diagnoses were respiratory failure or pneumonia, followed by sepsis and other diagnoses. Similar proportions of patients in both groups received invasive mechanical ventilation at the time of study enrollment. COVID-19 and non-COVID-19 patients had similar rates of acute respiratory distress syndrome, severe acute kidney injury, and in-hospital mortality. While concentrations of interleukin 6 and 8 were not different between groups, markers of epithelial cell injury (soluble receptor for advanced glycation end products, sRAGE) and acute phase proteins (serum amyloid A, SAA) were significantly higher in COVID-19 compared to non-COVID-19, adjusting for demographics and APACHE III scores. In contrast, angiopoietin 2:1 (Ang-2:1 ratio) and soluble tumor necrosis factor receptor 1 (sTNFR-1), markers of endothelial dysfunction and inflammation, were significantly lower in COVID-19 (p 

2021

covid-19, acute respiratory distress syndrome, Endothelial dysfunction, Critical illness

10.1186/s13054-021-03547-z

Epidemiology and Health

Korean Society of Epidemiology

Medical emergencies. Critical care. Intensive care. First aid