Version 1
: Received: 4 January 2023 / Approved: 4 January 2023 / Online: 4 January 2023 (04:37:40 CET)
Version 2
: Received: 7 January 2023 / Approved: 9 January 2023 / Online: 9 January 2023 (03:21:59 CET)
Zhang, Q.; Ye, Z.; Bignotti, A.; Zheng, X.L. Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19. J. Clin. Med.2023, 12, 552.
Zhang, Q.; Ye, Z.; Bignotti, A.; Zheng, X.L. Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19. J. Clin. Med. 2023, 12, 552.
Zhang, Q.; Ye, Z.; Bignotti, A.; Zheng, X.L. Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19. J. Clin. Med.2023, 12, 552.
Zhang, Q.; Ye, Z.; Bignotti, A.; Zheng, X.L. Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19. J. Clin. Med. 2023, 12, 552.
Abstract
Background: Endotheliopathy is common pathologic findings in patients with acute and long COVID-19. It may be associated with disease severity and predispose to long-term complications. Plasma levels of a proteoglycan syndecan-1 are found to be significantly elevated in patients with COVID-19, but its roles in assessing the disease severity and predicting long-term outcome are not fully understood. Methods: 124 consecutive hospitalized patients with SARS-CoV2 infection were prospectively enrolled and blood samples were collected on admission (T1), 3-4 days following treatment (T2), and 1-2 days prior to discharge or death (T3). Plasma levels of syndecan-1 were determined using an immunosorbent assay; various statistical analyses were performed to determine the association between plasma syndecan-1 levels and disease severity or the 60-day mortality rate. Results: Compared with those in the healthy controls, plasma levels of syndecan-1 in patients with critical COVID-19 were significantly higher (p<0.0001). However, there was no statistically significant difference among patients with different disease severity (p>0.05), resulting from large individual variability. Longitudinal analysis demonstrated that while the levels fluctuated during hospitalization in all patients, plasma syndecan-1 levels were persistently elevated from baseline in critical COVID19 patients. Cox proportional hazard regression analyses revealed that elevated plasma levels of syndecan-1 (>260 ng/mL at T1, >1018 ng/mL at T2, and >461 ng/mL at T3) were significantly associated with the 60-day mortality rate. Conclusions: Endotheliopathy, marked by glycocalyx degradation and elevated plasma syndecan-1, occurs in nearly all hospitalized patients with SARS-CoV2 infection; the elevated plasma syndecan-1 is associated with increased mortality in COVID-19 patients.
Keywords
COVID-19; endothelial dysfunction; glycocalyx degradation; sydencan-1; and mortality
Subject
Medicine and Pharmacology, Pathology and Pathobiology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Commenter: X. Long Zheng
Commenter's Conflict of Interests: Author