Plasma endostatin correlates with hypoxia and mortality in COVID-19-associated acute respiratory failure
(2021) In Biomarkers in Medicine 15(16). p.1509-1517- Abstract
Background: The contribution of endothelial injury in the pathogenesis of COVID-19-associated acute respiratory distress syndrome (ARDS) and resulting respiratory failure remains unclear. Plasma endostatin, an endogenous inhibitor of angiogenesis and endothelial dysfunction is upregulated during hypoxia, inflammation and progress of pulmonary disease. Aim: To investigate if plasma endostatin is associated to hypoxia, inflammation and 30-day mortality in patients with severe COVID-19 infection. Method: Samples for blood analysis and plasma endostatin quantification were collected from adult patients with ongoing COVID-19 (n = 109) on admission to intensive care unit (day 1). Demographic characteristics and 30-day mortality data were... (More)
Background: The contribution of endothelial injury in the pathogenesis of COVID-19-associated acute respiratory distress syndrome (ARDS) and resulting respiratory failure remains unclear. Plasma endostatin, an endogenous inhibitor of angiogenesis and endothelial dysfunction is upregulated during hypoxia, inflammation and progress of pulmonary disease. Aim: To investigate if plasma endostatin is associated to hypoxia, inflammation and 30-day mortality in patients with severe COVID-19 infection. Method: Samples for blood analysis and plasma endostatin quantification were collected from adult patients with ongoing COVID-19 (n = 109) on admission to intensive care unit (day 1). Demographic characteristics and 30-day mortality data were extracted from medical records. The ability of endostatin to predict mortality was analyzed using receiving operating characteristics and Kaplan-Meier analysis with a cutoff at 46.2 ng/ml was used to analyze the association to survival. Results: Plasma endostatin levels correlated with; PaO2/FiO2 (r = -0.3, p < 0.001), arterial oxygen tension (r = -0.2, p = 0.01), lactate (r = 0.2, p = 0.04), C-reactive protein (r = 0.2, p = 0.04), ferritin (r = 0.2, p = 0.09), D-dimer (r = 0.2, p = 0.08) and IL-6 (r = 0.4, p < 0.001). Nonsurvivors at 30 days had higher plasma endostatin levels than survivors (72 ± 26 vs 56 ± 16 ng/ml, p = 0.01). Receiving operating characteristic curve (area under the curve 0.7) showed that plasma endostatin >46.2 ng/ml predicts mortality with a sensitivity of 92% and specificity of 71%. In patients with plasma endostatin >46.2 ng/ml probability of survival was lower (p = 0.02) in comparison to those with endostatin <46.2 ng/ml. Conclusion: Our results suggest that plasma endostatin is an early biomarker for disease severity in COVID-19.
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- author
- Asif, Sana ; Ruge, Thoralph LU ; Larsson, Anders ; Anderberg, Sara Bülow ; Lipcsey, Miklos ; Fritiof, Robert and Hultström, Michael
- organization
- publishing date
- 2021-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ARDS, COVID-19, endostatin, hypoxia, inflammation, intensive care, pulmonary injury
- in
- Biomarkers in Medicine
- volume
- 15
- issue
- 16
- pages
- 9 pages
- publisher
- Future Medicine Ltd.
- external identifiers
-
- scopus:85119173567
- pmid:34668393
- ISSN
- 1752-0363
- DOI
- 10.2217/bmm-2021-0111
- language
- English
- LU publication?
- yes
- id
- 4c0aa2b8-1cbe-4bd6-acd3-007d81146ea9
- date added to LUP
- 2022-03-18 15:56:10
- date last changed
- 2024-04-18 06:37:08
@article{4c0aa2b8-1cbe-4bd6-acd3-007d81146ea9,
abstract = {{<p>Background: The contribution of endothelial injury in the pathogenesis of COVID-19-associated acute respiratory distress syndrome (ARDS) and resulting respiratory failure remains unclear. Plasma endostatin, an endogenous inhibitor of angiogenesis and endothelial dysfunction is upregulated during hypoxia, inflammation and progress of pulmonary disease. Aim: To investigate if plasma endostatin is associated to hypoxia, inflammation and 30-day mortality in patients with severe COVID-19 infection. Method: Samples for blood analysis and plasma endostatin quantification were collected from adult patients with ongoing COVID-19 (n = 109) on admission to intensive care unit (day 1). Demographic characteristics and 30-day mortality data were extracted from medical records. The ability of endostatin to predict mortality was analyzed using receiving operating characteristics and Kaplan-Meier analysis with a cutoff at 46.2 ng/ml was used to analyze the association to survival. Results: Plasma endostatin levels correlated with; PaO2/FiO2 (r = -0.3, p < 0.001), arterial oxygen tension (r = -0.2, p = 0.01), lactate (r = 0.2, p = 0.04), C-reactive protein (r = 0.2, p = 0.04), ferritin (r = 0.2, p = 0.09), D-dimer (r = 0.2, p = 0.08) and IL-6 (r = 0.4, p < 0.001). Nonsurvivors at 30 days had higher plasma endostatin levels than survivors (72 ± 26 vs 56 ± 16 ng/ml, p = 0.01). Receiving operating characteristic curve (area under the curve 0.7) showed that plasma endostatin >46.2 ng/ml predicts mortality with a sensitivity of 92% and specificity of 71%. In patients with plasma endostatin >46.2 ng/ml probability of survival was lower (p = 0.02) in comparison to those with endostatin <46.2 ng/ml. Conclusion: Our results suggest that plasma endostatin is an early biomarker for disease severity in COVID-19.</p>}},
author = {{Asif, Sana and Ruge, Thoralph and Larsson, Anders and Anderberg, Sara Bülow and Lipcsey, Miklos and Fritiof, Robert and Hultström, Michael}},
issn = {{1752-0363}},
keywords = {{ARDS; COVID-19; endostatin; hypoxia; inflammation; intensive care; pulmonary injury}},
language = {{eng}},
number = {{16}},
pages = {{1509--1517}},
publisher = {{Future Medicine Ltd.}},
series = {{Biomarkers in Medicine}},
title = {{Plasma endostatin correlates with hypoxia and mortality in COVID-19-associated acute respiratory failure}},
url = {{http://dx.doi.org/10.2217/bmm-2021-0111}},
doi = {{10.2217/bmm-2021-0111}},
volume = {{15}},
year = {{2021}},
}