ENDOTHELIAL BIOMARKERS IN PATIENTS RECOVERED FROM COVID-19 ONE YEAR AFTER HOSPITAL DISCHARGE: A CROSS-SECTIONAL STUDY   Endothelial biomarkers in COVID-19 recoverers one year after hospital discharge.

Main Article Content

Ming Tong
Xiquan Yan
Yu Jiang
Zhaoxia Jin
Shengjiao Zhu
Lianhong Zou
Yanjuan Liu
Qing Zheng
Guoqiang Chen
Ruifeng Gui Gui
Zhilan Zhou
Xiaotong Han
Jiangming He
Siqing Yin
Changchun Ma
Wen Xiao
Yong Zeng
Fang Chen
Yimin Zhu

Keywords

COVID-19, endothelial biomarkers, one-year follow-up, cardiovascular sequaele

Abstract

Background: COVID-19 is characterized by endothelial dysfunction and is presumed to have long-term cardiovascular sequelae. In this study, we aimed to explore the serum levels of endothelial biomarkers of COVID-19 recovers 1-year after hospital discharge.


Methods: A clinical follow-up study, including 345 COVID-19 survivors from Huanggang, Hubei, and 119 age and gender matched healthy controls were enrolled in the study. A standardized symptom questionnaire, electrocardiogram and Doppler ultrasound of lower extremities, routine blood tests, biochemical and immunological tests were collected, and serum levels of soluble vascular cell adhesion molecule-1(VCAM-1), intercellular cell adhesion molecule-1(ICAM-1), P-selectin, and fractalkine were measured by enzyme-linked immunosorbent assays.


Results: 1-year after discharge, 39% of recovers possessed post-COVID syndromes, while no deep vein thrombosis was detected in all screened. No significant differences in circulatory inflammatory markers (leukocytes, neutrophils, lymphocytes, C-reactive protein and interleukin-6), alanine aminotransferase, estimated glomerular filtration rate, glucose, triglycerides, total cholesterol and D-dimer observed among controls and previously mild or severe infected. Furthermore, serum levels of VCAM-1, ICAM-1, P-selectin, and fractalkine presented no significant differences between survivors and healthy controls.


Conclusions: SARS-CoV-2 infection may not impose a higher risk of long-term cardiovascular sequelae, even for those recovered from severe illness.


KEYWORDS: COVID, ENDOTHELIAL DYSFUNCTION, INFLAMMATORY MARKERS, ADHESION MOLECULES, THROMBOSIS.

Downloads

Download data is not yet available.
Abstract 57 | PDF Downloads 9 HTML Downloads 4

References

1. Johns Hopkins University. Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html. Accessed 30th October 2021.
2. Song WJ, Hui CKM, Hull JH, et al. Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses. The Lancet Respiratory medicine 2021; 9:533-44.
3. Ayoubkhani D, Khunti K, Nafilyan V, et al. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ (Clinical research ed) 2021; 372:n693.
4. Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nature medicine 2020; 26:1017-32.
5. Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nature reviews Cardiology 2020; 17:259-60.
6. Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. The New England journal of medicine 2020; 383:120-8.
7. Gu SX, Tyagi T, Jain K, et al. Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation. Nature reviews Cardiology 2021; 18:194-209.
8. Dou Q, Wei X, Zhou K, Yang S, Jia P. Cardiovascular Manifestations and Mechanisms in Patients with COVID-19. Trends in endocrinology and metabolism: TEM 2020; 31:893-904.
9. Li X, Sun X, Carmeliet P. Hallmarks of Endothelial Cell Metabolism in Health and Disease. Cell Metab 2019; 30:414-33.
10. Libby P, Lüscher T. COVID-19 is, in the end, an endothelial disease. European heart journal 2020; 41:3038-44.
11. Caligiuri G. CD31 as a Therapeutic Target in Atherosclerosis. Circ Res 2020; 126:1178-89.
12. Ford TJ, Ong P, Sechtem U, et al. Assessment of Vascular Dysfunction in Patients Without Obstructive Coronary Artery Disease: Why, How, and When. JACC Cardiovascular interventions 2020; 13:1847-64.
13. Polonsky TS, McDermott MM. Lower Extremity Peripheral Artery Disease Without Chronic Limb-Threatening Ischemia: A Review. Jama 2021; 325:2188-98.
14. Blevins BL, Vinters HV, Love S, et al. Brain arteriolosclerosis. Acta neuropathologica 2021; 141:1-24.
15. Tong M, Jiang Y, Xia D, et al. Elevated Expression of Serum Endothelial Cell Adhesion Molecules in COVID-19 Patients. The Journal of infectious diseases 2020; 222:894-8.
16. Zhang P, Li J, Liu H, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study. Bone research 2020; 8:8.
17. Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397:220-32.
18. Wang H, Li R, Zhou Z, et al. Cardiac involvement in COVID-19 patients: mid-term follow up by cardiovascular magnetic resonance. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 2021; 23:14.
19. Huang L, Zhao P, Tang D, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC Cardiovascular imaging 2020; 13:2330-9.
20. Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA cardiology 2020; 5:1265-73.
21. Xiong Q, Xu M, Li J, et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 2021; 27:89-95.
22. Sonnweber T, Sahanic S, Pizzini A, et al. Cardiopulmonary recovery after COVID-19: an observational prospective multicentre trial. The European respiratory journal 2021; 57.
23. Wu X, Deng KQ, Li C, et al. Cardiac Involvement in Recovered Patients From COVID-19: A Preliminary 6-Month Follow-Up Study. Frontiers in cardiovascular medicine 2021; 8:654405.
24. Münzel T, Sinning C, Post F, Warnholtz A, Schulz E. Pathophysiology, diagnosis and prognostic implications of endothelial dysfunction. Annals of medicine 2008; 40:180-96.
25. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340:1111-5.
26. Kitta Y, Obata JE, Nakamura T, et al. Persistent impairment of endothelial vasomotor function has a negative impact on outcome in patients with coronary artery disease. J Am Coll Cardiol 2009; 53:323-30.
27. Koga H, Sugiyama S, Kugiyama K, et al. Elevated levels of VE-cadherin-positive endothelial microparticles in patients with type 2 diabetes mellitus and coronary artery disease. J Am Coll Cardiol 2005; 45:1622-30.
28. Perico L, Benigni A, Casiraghi F, Ng LFP, Renia L, Remuzzi G. Immunity, endothelial injury and complement-induced coagulopathy in COVID-19. Nature reviews Nephrology 2021; 17:46-64.
29. Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet 2020; 395:1417-8.
30. Goshua G, Pine AB, Meizlish ML, et al. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. The Lancet Haematology 2020; 7:e575-e82.
31. Ong SWX, Fong SW, Young BE, et al. Persistent Symptoms and Association With Inflammatory Cytokine Signatures in Recovered Coronavirus Disease 2019 Patients. Open forum infectious diseases 2021; 8:ofab156.
32. Zhou M, Yin Z, Xu J, et al. Inflammatory profiles and clinical features of COVID-19 survivors three months after discharge in Wuhan, China. The Journal of infectious diseases 2021.
33. Daiber A, Steven S, Weber A, et al. Targeting vascular (endothelial) dysfunction. British journal of pharmacology 2017; 174:1591-619.
34. Kared H, Redd AD, Bloch EM, et al. SARS-CoV-2-specific CD8+ T cell responses in convalescent COVID-19 individuals. The Journal of clinical investigation 2021; 131.
35. Jin Y, Ji W, Yang H, Chen S, Zhang W, Duan G. Endothelial activation and dysfunction in COVID-19: from basic mechanisms to potential therapeutic approaches. Signal transduction and targeted therapy 2020; 5:293.