Serum Endocan Levels on Admission Are Associated With Worse Clinical Outcomes in COVID-19 Patients: A Pilot Study

Abstract

Thrombotic and embolic complications in the cardiovascular system are evident and associated with worse prognosis in coronavirus disease 2019 (COVID-19) patients. Endothelial-specific molecule 1 (endocan) plays a role in vascular pathology. We hypothesized serum endocan levels on admission are associated with primary composite end point (mortality and intensive care unit hospitalization) in COVID-19 patients. Patients (n = 80) with laboratory, clinical, and radiological confirmed COVID-19 were included in this cross-sectional study. Ten milliliter of peripheral venous blood were drawn within 24 hours of admission to estimate serum endocan levels. Data were analyzed using SPSS version 26.0 (IBM). Patients with the primary composite end point had significantly higher serum endocan levels than patients without (852.2 ± 522.7 vs 550.2 ± 440.8 ng/L, respectively; P < .01). In the logistic regression analysis, only increased serum endocan levels and increase in age were independent predictors of the primary composite end point ( P < .05). In the receiver operating characteristics curve analysis, we found that a serum endocan level of 276.4 ng/L had a 97% sensitivity and 85% specificity for prediction of the primary composite end point. Baseline serum endocan levels may prove useful as a prognostic factor in patients hospitalized for COVID-19.

Thrombotic thrombocytopenia associated with COVID-19 infection or vaccination: Possible paths to platelet factor 4 autoimmunity

“…Circulating PF4 could form complexes with endogenous polyanionic PGs released by damaged endothelial cells. Syndecan-1 and endocan are potential PG candidates since their serum levels are increased in severely ill COVID-19 patients in association with other markers of endothelial injury [38][39][40]. Complexes formed between PF4 and endothelial cell-derived polyanionic PG would then stimulate extrafollicular B cells producing anti-PF4 antibodies.…”

Is There Association Between Midkine Levels and Prognosis of Covid-19 Di̇sease?

“…3 Many COVID-19 related mortality biomarkers such as D-Dimer, C-reactive protein (CRP), Ferritin, pentraxin-3 and proinflammatory cytokines elevation have been demonstrated. [4][5][6][7][8][9][10] However, the search for different disease-specific biomarkers continues. Midkine (MK) is a multifunctional cytokine, expressed primarily in midgestation.…”

COVID-19 and Endocan Levels

“…2,3 COVID-19 symptoms range from asymptomatic to mild respiratory symptoms and even potentially life-threatening pulmonary and CV complications. 4 Respiratory tract problems are the most important clinical manifestations. However, COVID-19 can also cause serious cardiac problems in patients with/without underlying heart problems.…”

“…However, COVID-19 can also cause serious cardiac problems in patients with/without underlying heart problems. 4 These include acute myocardial injury, arrhythmias, cardiogenic shock, and even sudden death. 4 Therefore, any marker that predicts the risk of CV events or poor prognosis in these patients is clinically relevant.…”

“…In this issue of the journal, 4 Medetalibeyoglu et al report a significant relationship between serum endocan levels and a primary composite end point consisting of mortality and the need for intensive care unit in COVID-19 patients. This study provides further support to the concepts discussed above.…”