Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19
Background: Endotheliopathy is a common pathologic finding in patients with acute and long COVID-19. It may be associated with disease severity and predispose patients to long-term complications. Plasma levels of a proteoglycan, syndecan-1, are found to be significantly elevated in patients with COV...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/2/552 |
| _version_ | 1797440705535148032 |
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| author | Quan Zhang Zhan Ye Antonia Bignotti X. Long Zheng |
| author_facet | Quan Zhang Zhan Ye Antonia Bignotti X. Long Zheng |
| author_sort | Quan Zhang |
| collection | DOAJ |
| description | Background: Endotheliopathy is a common pathologic finding in patients with acute and long COVID-19. It may be associated with disease severity and predispose patients 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 disease severity and predicting long-term outcome are not fully understood. Methods: A total of 124 consecutive hospitalized patients with SARS-CoV-2 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 (<i>p</i> < 0.0001). However, there was no statistically significant difference among patients with different disease severity (<i>p</i> > 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 COVID-19 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-CoV-2 infection; elevated plasma syndecan-1 is associated with increased mortality in COVID-19 patients. |
| first_indexed | 2024-03-09T12:12:10Z |
| format | Article |
| id | doaj.art-d24a577f5e23487e8051b70bfbffdc81 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T12:12:10Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d24a577f5e23487e8051b70bfbffdc812023-11-30T22:51:29ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112255210.3390/jcm12020552Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19Quan Zhang0Zhan Ye1Antonia Bignotti2X. Long Zheng3Departments of Pathology and Laboratory Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, USADepartments of Pathology and Laboratory Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, USADepartments of Pathology and Laboratory Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, USADepartments of Pathology and Laboratory Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, USABackground: Endotheliopathy is a common pathologic finding in patients with acute and long COVID-19. It may be associated with disease severity and predispose patients 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 disease severity and predicting long-term outcome are not fully understood. Methods: A total of 124 consecutive hospitalized patients with SARS-CoV-2 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 (<i>p</i> < 0.0001). However, there was no statistically significant difference among patients with different disease severity (<i>p</i> > 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 COVID-19 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-CoV-2 infection; elevated plasma syndecan-1 is associated with increased mortality in COVID-19 patients.https://www.mdpi.com/2077-0383/12/2/552COVID-19endothelial dysfunctionglycocalyx degradationsyndecan-1mortality |
| spellingShingle | Quan Zhang Zhan Ye Antonia Bignotti X. Long Zheng Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 Journal of Clinical Medicine COVID-19 endothelial dysfunction glycocalyx degradation syndecan-1 mortality |
| title | Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 |
| title_full | Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 |
| title_fullStr | Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 |
| title_full_unstemmed | Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 |
| title_short | Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19 |
| title_sort | longitudinal assessment of plasma syndecan 1 predicts 60 day mortality in patients with covid 19 |
| topic | COVID-19 endothelial dysfunction glycocalyx degradation syndecan-1 mortality |
| url | https://www.mdpi.com/2077-0383/12/2/552 |
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