Endocan as a potential marker in diagnosis and predicting disease severity in COVID-19 patients: a promising biomarker for patients with false-negative RT-PCR

Abstract

Background: Endothelial-specific molecule 1 (endocan) has emerged as an inflammatory biomarker in recent years. The purpose of this study was to investigate the diagnostic value of serum endocan levels in the prediction of COVID-19 disease among patients with a false-negative reverse transcription polymerase change reaction (RT-PCR) test, and also to determine its correlation with the clinical severity of the disease.
 Methods: Thirty patients with positive RT-PCR results and 30 with false-negative RT-PCR results, both with suspected COVID-19 in terms of clinical, radiological, and laboratory findings, were included in the study. Thirty healthy controls were also enrolled.
 Results: Serum endocan levels were estimated to be 821.8 ± 99.3 pg/mL in COVID-19 RT-PCR (+) patients, 803.9 ± 97.0 pg/mL in RT-PCR false (–) patients with suspected COVID-19, and 382.9 ± 37.5 pg/mL in the control group. No significant difference was observed between RT-PCR (+) and RT-PCR false (–) patients (P = 0.68). However, serum endocan levels differed significantly between patient groups and control group (P < 0.05). With a cut-off value of 444.2 pg/mL serum endocan levels differentiated COVID-19 cases from healthy individuals with 92% sensitivity and 80% specificity. Moreover, a significant positive correlation was observed between serum endocan levels and clinical severity (P < 0.01, r = 0.94).
 Conclusions: There is a need for different laboratory markers capable of assisting diagnosis and showing COVID-19 infection in suspected COVID-19 RT-PCR false-negative patients. Endocan levels can be used as an assistant blood test for identifying COVID-19 patients with false-negative RT-PCR tests and in determining the clinical severity of the disease.

Serum Endocan Levels and Subclinical Atherosclerosis in Patients with Chronic Kidney and End-Stage Renal Diseases

“…Serum endocan levels showed significant changes in many acute and chronic conditions [ 14 , 15 ]. The present study found significantly higher endocan levels in patients' groups as compared to healthy controls.…”

Plasma Endocan as a Biomarker of Thrombotic Events in COVID-19 Patients

“…Thromboinflammation, endotheliopathy and coagulopathy are frequent in severe COVID-19 [ 18 ], and thrombotic events are associated with worse prognoses in COVID-19 [ 19 ]. Very recently, several studies reported on potential interest in serum endocan as a potential marker in the diagnosis and prediction of disease severity in COVID-19 [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ], and most of them also mentioned the importance of this marker’s connection with thrombosis. However, none of them specifically focused on the potential role of endocan in identifying thrombotic injury in COVID-19, nor investigate the mechanistic importance of endocan in thromboinflammation.…”

Systematic Review of Endocan as a Potential Biomarker of COVID-19

“…Subsequently, 48 articles were excluded due to various reasons, while one was added by reference searching, as described in Figure 1. Finally, eight studies, [11][12][13][14][15][16][17][18] including 686 cases, were included in the systematic review. A detailed flowchart of the search and selection process is shown in Figure 1.…”

“…The mean age of participants was 60.1 ± 14.0 years, and 62.9% were male. Four studies 11,12,15,18 measured endocan in plasma, and the other four 13,14,16,17 measured serum endocan levels. Half of the studies were conducted in Turkey 13,14,16,17 and three in France.…”