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Plasma endostatin correlates with hypoxia and mortality in COVID-19-associated acute respiratory failure

Asif, Sana ; Ruge, Thoralph LU ; Larsson, Anders ; Anderberg, Sara Bülow ; Lipcsey, Miklos ; Fritiof, Robert and Hultström, Michael (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
; ; ; ; ; and
organization
publishing date
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
2024-02-17 21:50:51
@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 &lt; 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 &lt; 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 &gt;46.2 ng/ml predicts mortality with a sensitivity of 92% and specificity of 71%. In patients with plasma endostatin &gt;46.2 ng/ml probability of survival was lower (p = 0.02) in comparison to those with endostatin &lt;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}},
}