Endothelial Dysfunction and SARS-CoV-2 Infection: Association and Therapeutic Strategies

Deng, Hai; Tang, Ting-Xuan; Deng, Chao; Tang, Liangsheng; Xiang, Yang; Tang, Zhaohui

doi:10.3390/pathogens10050582

Cited by 20 publications

(26 citation statements)

References 100 publications

(213 reference statements)

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“…Known to reduce COVID-19 mortality [15][16][17], statins that were prescribed to hyperlipidemic patients may account for patients' protection against COVID-19 associated death. In addition to their primary lipid-lowering effect, statins appear to regulate vasodilation via a receptor of the novel coronavirus, angiotensin-converting enzyme 2 (ACE2) [18]. As a well-characterized regulator of pulmonary vasodilation, ACE2may also exert beneficial secondary vascular effects such as dilation of lung vessels [19].…”

Section: Discussionmentioning

confidence: 99%

Susceptibility of β-Thalassemia Heterozygotes to COVID-19

Sotiriou

Samara

Vamvakopoulou

et al. 2021

JCM

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Background: β-Thalassemia is the most prevalent single gene blood disorder, while the assessment of its susceptibility to coronavirus disease 2019 (COVID-19) warrants it a pressing biomedical priority. Methods: We studied 255 positive COVID-19 participants unvaccinated against severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2), consecutively recruited during the last trimester of 2020. Patient characteristics including age, sex, current smoking status, atrial fibrillation, chronic respiratory disease, coronary disease, diabetes, neoplasia, hyperlipidemia, hypertension, and β-thalassemia heterozygosity were assessed for COVID-19 severity, length of hospitalization, intensive care unit (ICU) admission and mortality from COVID-19. Results: We assessed patient characteristics associated with clinical symptoms, ICU admission, and mortality from COVID-19. In multivariate analysis, severe-critical COVID-19 was strongly associated with male sex (p = 0.023), increased age (p < 0.001), and β-thalassemia heterozygosity (p = 0.002, OR = 2.89). Regarding the requirement for ICU care, in multivariate analysis there was a statistically significant association with hypertension (p = 0.001, OR = 5.12), while β-thalassemia heterozygosity had no effect (p = 0.508, OR = 1.33). Mortality was linked to male sex (p = 0.036, OR = 2.09), increased age (p < 0.001) and β-thalassemia heterozygosity (p = 0.010, OR = 2.79) in multivariate analysis. It is worth noting that hyperlipidemia reduced mortality from COVID-19 (p = 0.008, OR = 0.38). No statistically significant association of current smoking status with patient characteristics studied was observed. Conclusions: Our pilot observations indicate enhanced mortality of β-thalassemia heterozygotes from COVID-19.

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Section: Discussionmentioning

confidence: 99%

Susceptibility of β-Thalassemia Heterozygotes to COVID-19

Sotiriou

Samara

Vamvakopoulou

et al. 2021

JCM

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“…Active suPAR may assist in the early triage of SARS-CoV-2-infected persons to prevent virus transmission [22]. Since the regulation of coagulation and thrombolysis, and the promotion of hemofluidity aid in maintaining unobstructed blood flow, targeting these pathways could be a focus of therapy-based approaches in COVID-19 [23]. Furthermore, excessive activation of host innate immune system and coagulation responses can lead to multi-organ failure and death [24].…”

Section: Ephrin-a1 and Epha2mentioning

confidence: 99%

Endothelial, Immunothrombotic, and Inflammatory Biomarkers in the Risk of Mortality in Critically Ill COVID-19 Patients: The Role of Dexamethasone

et al. 2021

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Endothelial dysfunction, coagulation and inflammation biomarkers are increasingly emerging as prognostic markers of poor outcomes and mortality in severe and critical COVID-19. However, the effect of dexamethasone has not been investigated on these biomarkers. Hence, we studied potential prognostic biomarkers of mortality in critically ill COVID-19 patients who had either received or not dexamethasone. Biomarker serum levels were measured on intensive care unit (ICU) admission (within 24 h) in 37 dexamethasone-free and 29 COVID-19 patients who had received the first dose (6 mg) of dexamethasone. Receiver operating characteristic (ROC) curves were generated to assess their value in ICU mortality prediction, while Kaplan–Meier analysis was used to explore associations between biomarkers and survival. In the dexamethasone-free COVID-19 ICU patients, non-survivors had considerably higher levels of various endothelial, immunothrombotic and inflammatory biomarkers. In the cohort who had received one dexamethasone dose, non-survivors had higher ICU admission levels of only soluble (s) vascular cell adhesion molecule-1 (VCAM-1), soluble urokinase-type plasminogen activator receptor (suPAR) and presepsin. As determined from the generated ROC curves, sVCAM-1, suPAR and presepsin could still be reliable prognostic ICU mortality biomarkers, following dexamethasone administration (0.7 < AUC < 0.9). Moreover, the Kaplan–Meier survival analysis showed that patients with higher than the median values for sVCAM-1 or suPAR exhibited a greater mortality risk than patients with lower values (Log-Rank test, p < 0.01). In our single-center study, sVCAM-1, suPAR and presepsin appear to be valuable prognostic biomarkers in assessing ICU mortality risk in COVID-19 patients, even following dexamethasone administration.

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“…Кроме того, поступление SARS-CoV-2 через ACE2 индуцирует пониженную регуляцию экспрессии мембраносвязанного ACE2, что, в свою очередь, может косвенно активировать калликреин-кининовую систему и, в конечном итоге, привести к увеличению проницаемости сосудов. Повышенная проницаемость сосудов может способствовать экстравазации и накоплению жидкостей, белков и различных воспалительных факторов в альвеолярном пространстве и влиять на функцию оксигенации [75]. Это открытие напрямую связывает повреждение эндотелия с повышением проницаемости капилляров и обострением острого респираторного дистресс-синдрома взрослых при COVID-19 [74,75].…”

Section: Covid-19 и перинатальные рискиunclassified

Systemic endotheliitis in terms of novel coronavirus infection COVID-19: gender-related and perinatal risks

Chkhaidze

Lioznov

Петрищев³

et al. 2022

Regional blood circulation and microcirculation

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The review considers some physiological features that reflect gender differences in the susceptibility to a novel coronavirus infection. Up-to-date information on the impact of COVID-19 on the course of pregnancy and perinatal outcomes is presented. The debatable issues of the possibility of vertical transmission of the SARS-CoV-2 virus are highlighted based on the analysis of available literature data and recommendations of international professional communities.

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Endothelial Dysfunction and SARS-CoV-2 Infection: Association and Therapeutic Strategies

Cited by 20 publications

References 100 publications

Susceptibility of β-Thalassemia Heterozygotes to COVID-19

Susceptibility of β-Thalassemia Heterozygotes to COVID-19

Endothelial, Immunothrombotic, and Inflammatory Biomarkers in the Risk of Mortality in Critically Ill COVID-19 Patients: The Role of Dexamethasone

Systemic endotheliitis in terms of novel coronavirus infection COVID-19: gender-related and perinatal risks

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