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10.1007/s10456-020-09730-0

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32458111!7250589!32458111
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suck abstract from ncbi


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pmid32458111      Angiogenesis 2020 ; 23 (4): 611-620
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  • Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients #MMPMID32458111
  • Smadja DM; Guerin CL; Chocron R; Yatim N; Boussier J; Gendron N; Khider L; Hadjadj J; Goudot G; Debuc B; Juvin P; Hauw-Berlemont C; Augy JL; Peron N; Messas E; Planquette B; Sanchez O; Charbit B; Gaussem P; Duffy D; Terrier B; Mirault T; Diehl JL
  • Angiogenesis 2020[Nov]; 23 (4): 611-620 PMID32458111show ga
  • BACKGROUND: Coronavirus disease-2019 (COVID-19), a respiratory disease has been associated with ischemic complications, coagulation disorders, and an endotheliitis. OBJECTIVES: To explore endothelial damage and activation-related biomarkers in COVID-19 patients with criteria of hospitalization for referral to intensive care unit (ICU) and/or respiratory worsening. METHODS: Analysis of endothelial and angiogenic soluble markers in plasma from patients at admission. RESULTS: Study enrolled 40 consecutive COVID-19 patients admitted to emergency department that fulfilled criteria for hospitalization. Half of them were admitted in conventional wards without any ICU transfer during hospitalization; whereas the 20 others were directly transferred to ICU. Patients transferred in ICU were more likely to have lymphopenia, decreased SpO2 and increased D-dimer, CRP and creatinine levels. In those patients, soluble E-selectin and angiopoietin-2 were significantly increased (p value at 0.009 and 0.003, respectively). Increase in SELE gene expression (gene coding for E-selectin protein) was confirmed in an independent cohort of 32 patients using a whole blood gene expression profile analysis. In plasma, we found a strong association between angiopoetin-2 and CRP, creatinine and D-dimers (with p value at 0.001, 0.001 and 0.003, respectively). ROC curve analysis identified an Angiopoietin-2 cut-off of 5000 pg/mL as the best predictor for ICU outcome (Se = 80.1%, Sp = 70%, PPV = 72.7%, NPV = 77%), further confirmed in multivariate analysis after adjustment for creatinine, CRP or D-dimers. CONCLUSION: Angiopoietin-2 is a relevant predictive factor for ICU direct admission in COVID-19 patients. This result showing an endothelial activation reinforces the hypothesis of a COVID-19-associated microvascular dysfunction.
  • |*Intensive Care Units[MESH]
  • |Aged[MESH]
  • |Angiopoietin-2/*blood[MESH]
  • |Betacoronavirus[MESH]
  • |Biomarkers/blood[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*blood/*therapy[MESH]
  • |Critical Care/methods[MESH]
  • |E-Selectin/blood[MESH]
  • |Endothelium, Vascular/*metabolism[MESH]
  • |Female[MESH]
  • |Gene Expression Profiling[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Patient Admission[MESH]
  • |Pneumonia, Viral/*blood/*therapy[MESH]
  • |Prospective Studies[MESH]
  • |Respiration, Artificial[MESH]


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