PDF(Pubmed)
Abstract：
BACKGROUND: SARS-CoV-2 is a systemic disease that affects endothelial function and leads to coagulation disorders, increasing the risk of mortality. Blood levels of endothelial biomarkers such as Von Willebrand Factor (VWF), Thrombomodulin or Blood Dendritic Cell Antigen-3 (BDCA3), and uUokinase (uPA) increase in patients with severe disease and can be prognostic indicators for mortality. Therefore, the aim of this study was to determine the effect of VWF, BDCA3, and uPA levels on mortality.
METHODS: From May 2020 to January 2021, we studied a prospective cohort of hospitalized adult patients with polymerase chain reaction (PCR)-confirmed COVID-19 with a SaO2 ≤ 93% and a PaO2/FiO2 ratio < 300. In-hospital survival was evaluated from admission to death or to a maximum of 60 days of follow-up with Kaplan-Meier survival curves and Cox proportional hazard models as independent predictor measures of endothelial dysfunction.
RESULTS: We recruited a total of 165 subjects (73% men) with a median age of 57.3 ± 12.9 years. The most common comorbidities were obesity (39.7%), hypertension (35.4%) and diabetes (30.3%). Endothelial biomarkers were increased in non-survivors compared to survivors. According to the multivariate Cox proportional hazard model, those with an elevated VWF concentration ≥ 4870 pg/ml had a hazard ratio (HR) of 4.06 (95% CI: 1.32-12.5) compared to those with a lower VWF concentration adjusted for age, cerebrovascular events, enoxaparin dose, lactate dehydrogenase (LDH) level, and bilirubin level. uPA and BDCA3 also increased mortality in patients with levels ≥ 460 pg/ml and ≥ 3600 pg/ml, respectively.
CONCLUSIONS: The risk of mortality in those with elevated levels of endothelial biomarkers was observable in this study.
METHODS: From May 2020 to January 2021, we studied a prospective cohort of hospitalized adult patients with polymerase chain reaction (PCR)-confirmed COVID-19 with a SaO2 ≤ 93% and a PaO2/FiO2 ratio < 300. In-hospital survival was evaluated from admission to death or to a maximum of 60 days of follow-up with Kaplan-Meier survival curves and Cox proportional hazard models as independent predictor measures of endothelial dysfunction.
RESULTS: We recruited a total of 165 subjects (73% men) with a median age of 57.3 ± 12.9 years. The most common comorbidities were obesity (39.7%), hypertension (35.4%) and diabetes (30.3%). Endothelial biomarkers were increased in non-survivors compared to survivors. According to the multivariate Cox proportional hazard model, those with an elevated VWF concentration ≥ 4870 pg/ml had a hazard ratio (HR) of 4.06 (95% CI: 1.32-12.5) compared to those with a lower VWF concentration adjusted for age, cerebrovascular events, enoxaparin dose, lactate dehydrogenase (LDH) level, and bilirubin level. uPA and BDCA3 also increased mortality in patients with levels ≥ 460 pg/ml and ≥ 3600 pg/ml, respectively.
CONCLUSIONS: The risk of mortality in those with elevated levels of endothelial biomarkers was observable in this study.
摘要：
背景：SARS-CoV-2是一种影响内皮功能并导致凝血功能紊乱的全身性疾病，增加死亡风险。血管内皮生物标志物如血管性血友病因子（VWF）的血液水平，血栓调节蛋白或血液树突状细胞抗原-3（BDCA3），严重疾病患者尿激酶（uPA）增加，可以作为死亡率的预后指标。因此,这项研究的目的是确定VWF的效果，BDCA3和uPA水平对死亡率的影响。
方法：从2020年5月至2021年1月，我们对聚合酶链反应(PCR)证实为CoVID-19的SaO2≤93%，PaO2/FiO2比值<300的住院成年患者进行了前瞻性队列研究。使用Kaplan-Meier生存曲线和Cox比例风险模型作为内皮功能障碍的独立预测指标，评估从入院到死亡或最长60天随访的住院生存率。
结果：我们共招募了165名受试者（73%为男性），中位年龄为57.3±12.9岁。最常见的合并症是肥胖（39.7%），高血压(35.4%)和糖尿病(30.3%)。与幸存者相比，非幸存者的内皮生物标志物增加。根据多变量Cox比例风险模型，VWF浓度升高≥4870pg/ml的患者与VWF浓度较低的患者相比，风险比（HR）为4.06（95％CI：1.32-12.5）。脑血管事件，依诺肝素剂量,乳酸脱氢酶（LDH）水平，和胆红素水平。uPA和BDCA3也增加了≥460pg/ml和≥3600pg/ml患者的死亡率，分别。
结论：在这项研究中可以观察到内皮生物标志物水平升高的患者的死亡风险。
方法：从2020年5月至2021年1月，我们对聚合酶链反应(PCR)证实为CoVID-19的SaO2≤93%，PaO2/FiO2比值<300的住院成年患者进行了前瞻性队列研究。使用Kaplan-Meier生存曲线和Cox比例风险模型作为内皮功能障碍的独立预测指标，评估从入院到死亡或最长60天随访的住院生存率。
结果：我们共招募了165名受试者（73%为男性），中位年龄为57.3±12.9岁。最常见的合并症是肥胖（39.7%），高血压(35.4%)和糖尿病(30.3%)。与幸存者相比，非幸存者的内皮生物标志物增加。根据多变量Cox比例风险模型，VWF浓度升高≥4870pg/ml的患者与VWF浓度较低的患者相比，风险比（HR）为4.06（95％CI：1.32-12.5）。脑血管事件，依诺肝素剂量,乳酸脱氢酶（LDH）水平，和胆红素水平。uPA和BDCA3也增加了≥460pg/ml和≥3600pg/ml患者的死亡率，分别。
结论：在这项研究中可以观察到内皮生物标志物水平升高的患者的死亡风险。
