Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis
Background & Aims: Endothelial injury and dysfunction play a detrimental role in the pathogenesis of infections. Endothelium-related molecules have been reported as potential diagnostic and/or prognostic biomarkers of infection. The prognostic value of these biomarkers in patients with cirrh...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
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Elsevier
2021-08-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555921000793 |
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| author | Savneet Kaur Sadam Hussain Kailash Kolhe Guresh Kumar Dinesh M. Tripathi Arvind Tomar Pratibha Kale Ashad Narayanan Chaggan Bihari Meenu Bajpai Rakhi Maiwall Ekta Gupta Shiv K. Sarin |
| author_facet | Savneet Kaur Sadam Hussain Kailash Kolhe Guresh Kumar Dinesh M. Tripathi Arvind Tomar Pratibha Kale Ashad Narayanan Chaggan Bihari Meenu Bajpai Rakhi Maiwall Ekta Gupta Shiv K. Sarin |
| author_sort | Savneet Kaur |
| collection | DOAJ |
| description | Background & Aims: Endothelial injury and dysfunction play a detrimental role in the pathogenesis of infections. Endothelium-related molecules have been reported as potential diagnostic and/or prognostic biomarkers of infection. The prognostic value of these biomarkers in patients with cirrhosis and infections remains elusive. Methods: In this study, we investigated the performance of key soluble endothelial injury biomarkers, including intercellular adhesion molecule 1 (ICAM1), von Willebrand factor (vWF), vascular endothelial growth factor receptor 1 (VEGFR1), and angiopoietin 1 and 2 (Ang1, 2) as mortality predictors in patients with cirrhosis and severe COVID-19 or bacterial sepsis. Results: A total of 66 hospitalized patients (admitted to the COVID-19 ward or liver intensive care unit [ICU]) were included. Twenty-two patients had COVID-19 alone, while 20 patients had cirrhosis plus COVID-19. Twenty-four patients had cirrhosis plus bacterial sepsis. Among patients with cirrhosis, the most common aetiology of liver disease was alcohol. ICAM1 was increased (p = 0.003) while VEGFR1 (p <0.0001) and Ang1 (p <0.0001) were reduced in patients with COVID-19 and cirrhosis, compared to patients with COVID-19 alone. Endothelial biomarker levels did not differ significantly between patients with cirrhosis and severe COVID-19 or bacterial sepsis in the ICU. In these patients, ICAM1 levels significantly and independently predicted mortality (hazard ratio 3.24; 95% CI 1.19–8.86) along with model for end-stage liver disease (MELD) score, renal and coagulation failures. The AUC for ICAM1 was 0.74, MELD was 0.60 and combined ICAM1 and MELD was 0.70. ICAM1 also positively correlated with the composite organ failure scores recorded 3–5 days post ICU admission (CLIF-OF and SOFA) in this subgroup of patients. Conclusion: The study indicates that in patients with cirrhosis, elevated plasma ICAM1 serves as an independent predictor of severe COVID-19- or sepsis-associated 28-day mortality. Lay summary: Bacterial sepsis and COVID-19 lead to increased mortality in patients with cirrhosis. In this study, we demonstrate that high plasma levels of ICAM1, an endothelial injury biomarker, is one of the important factors predicting mortality in critically ill cirrhotic patients with severe COVID-19 or bacterial sepsis. |
| first_indexed | 2024-12-16T11:04:39Z |
| format | Article |
| id | doaj.art-ddc863fdd9e34b55b9f63bfe8b9980df |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-12-16T11:04:39Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj.art-ddc863fdd9e34b55b9f63bfe8b9980df2022-12-21T22:33:54ZengElsevierJHEP Reports2589-55592021-08-0134100303Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsisSavneet Kaur0Sadam Hussain1Kailash Kolhe2Guresh Kumar3Dinesh M. Tripathi4Arvind Tomar5Pratibha Kale6Ashad Narayanan7Chaggan Bihari8Meenu Bajpai9Rakhi Maiwall10Ekta Gupta11Shiv K. Sarin12Department of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India; Corresponding authors. Addresses: Department of Molecular and Cellular Medicine Institute of Liver and Biliary Sciences (ILBS), D1, Vasant Kunj, New Delhi 110070, IndiaDepartment of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India; Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, IndiaDepartment of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, India; Department of Research and Biostatistics, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Molecular and Cellular Medicine, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Pulmonary Medicine, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Microbiology, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Emergency, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Pathology, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Transfusion Medicine, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Hepatology, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Virology, Institute of liver and biliary Sciences, New Delhi, IndiaDepartment of Hepatology, Institute of liver and biliary Sciences, New Delhi, India; Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), D1, Vasant Kunj, New Delhi 110070, IndiaBackground & Aims: Endothelial injury and dysfunction play a detrimental role in the pathogenesis of infections. Endothelium-related molecules have been reported as potential diagnostic and/or prognostic biomarkers of infection. The prognostic value of these biomarkers in patients with cirrhosis and infections remains elusive. Methods: In this study, we investigated the performance of key soluble endothelial injury biomarkers, including intercellular adhesion molecule 1 (ICAM1), von Willebrand factor (vWF), vascular endothelial growth factor receptor 1 (VEGFR1), and angiopoietin 1 and 2 (Ang1, 2) as mortality predictors in patients with cirrhosis and severe COVID-19 or bacterial sepsis. Results: A total of 66 hospitalized patients (admitted to the COVID-19 ward or liver intensive care unit [ICU]) were included. Twenty-two patients had COVID-19 alone, while 20 patients had cirrhosis plus COVID-19. Twenty-four patients had cirrhosis plus bacterial sepsis. Among patients with cirrhosis, the most common aetiology of liver disease was alcohol. ICAM1 was increased (p = 0.003) while VEGFR1 (p <0.0001) and Ang1 (p <0.0001) were reduced in patients with COVID-19 and cirrhosis, compared to patients with COVID-19 alone. Endothelial biomarker levels did not differ significantly between patients with cirrhosis and severe COVID-19 or bacterial sepsis in the ICU. In these patients, ICAM1 levels significantly and independently predicted mortality (hazard ratio 3.24; 95% CI 1.19–8.86) along with model for end-stage liver disease (MELD) score, renal and coagulation failures. The AUC for ICAM1 was 0.74, MELD was 0.60 and combined ICAM1 and MELD was 0.70. ICAM1 also positively correlated with the composite organ failure scores recorded 3–5 days post ICU admission (CLIF-OF and SOFA) in this subgroup of patients. Conclusion: The study indicates that in patients with cirrhosis, elevated plasma ICAM1 serves as an independent predictor of severe COVID-19- or sepsis-associated 28-day mortality. Lay summary: Bacterial sepsis and COVID-19 lead to increased mortality in patients with cirrhosis. In this study, we demonstrate that high plasma levels of ICAM1, an endothelial injury biomarker, is one of the important factors predicting mortality in critically ill cirrhotic patients with severe COVID-19 or bacterial sepsis.http://www.sciencedirect.com/science/article/pii/S2589555921000793BiomarkersCOVID-19Endothelial InjuryLiver CirrhosisSepsis |
| spellingShingle | Savneet Kaur Sadam Hussain Kailash Kolhe Guresh Kumar Dinesh M. Tripathi Arvind Tomar Pratibha Kale Ashad Narayanan Chaggan Bihari Meenu Bajpai Rakhi Maiwall Ekta Gupta Shiv K. Sarin Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis JHEP Reports Biomarkers COVID-19 Endothelial Injury Liver Cirrhosis Sepsis |
| title | Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis |
| title_full | Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis |
| title_fullStr | Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis |
| title_full_unstemmed | Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis |
| title_short | Elevated plasma ICAM1 levels predict 28-day mortality in cirrhotic patients with COVID-19 or bacterial sepsis |
| title_sort | elevated plasma icam1 levels predict 28 day mortality in cirrhotic patients with covid 19 or bacterial sepsis |
| topic | Biomarkers COVID-19 Endothelial Injury Liver Cirrhosis Sepsis |
| url | http://www.sciencedirect.com/science/article/pii/S2589555921000793 |
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