背景:2019年冠状病毒病(COVID-19)大流行,由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,产生了深远的全球影响,全球数百万例确诊病例和死亡病例。虽然大多数病例是温和的,一个子集进展为严重的呼吸系统并发症和死亡,有血栓栓塞等因素,年龄,和潜在的健康状况增加了风险。血管内皮损伤与严重的预后有关,但具体的生物标志物仍然难以捉摸。本研究调查了syndecan-1(SDC-1),内皮损伤的标志,作为COVID-19的潜在预后因素,重点是日本人群,以其人口老龄化和高发合并症而闻名。
方法:对日本福岛县2020年2月至2021年8月间收治的COVID-19患者进行了多中心回顾性研究。测量SDC-1水平以及其他临床和实验室参数。结果包括血栓形成,28天存活,并评估了疾病的严重程度,根据既定指南对疾病严重程度进行分类.
结果:SDC-1水平与疾病严重程度相关。死于COVID-19的患者SDC-1水平高于幸存者,受试者工作特征曲线下面积(AUC)分析表明,SDC-1水平可能是死亡率的预测因子(AUC0.714).K-M分析还显示,基于10.65ng/mL的SDC-1截止值,生存率存在显着差异。
结论:这项研究表明,SDC-1可能是评估COVID-19严重程度和预测住院28天内死亡率的有价值的生物标志物,特别是在日本人口中。然而,需要进一步调查以评估SDC-1水平的纵向变化,验证其对长期生存的预测价值,并考虑其对新病毒变体的适用性。
结论:SDC-1正在成为评估日本人群COVID-19严重程度和预期寿命的潜在生物标志物,在持续的抗击病毒的斗争中,为改善风险分层和患者管理提供了希望。
BACKGROUND: The
coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), has had a profound global impact, with millions of confirmed cases and deaths worldwide. While most cases are mild, a subset progresses to severe respiratory complications and death, with factors such as thromboembolism, age, and underlying health conditions increasing the risk. Vascular endothelial damage has been implicated in severe outcomes, but specific biomarkers remain elusive. This
study investigated syndecan-1 (SDC-1), a marker of endothelial damage, as a potential prognostic factor for COVID-19, focusing on the Japanese population, which is known for its aging demographics and high prevalence of comorbidities.
METHODS: A multicenter retrospective
study of COVID-19 patients in Fukushima Prefecture in Japan who were admitted between February 2020 and August 2021 was conducted. SDC-1 levels were measured along with other clinical and laboratory parameters. Outcomes including thrombosis, 28-day survival, and disease severity were assessed, and disease severity was categorized according to established guidelines.
RESULTS: SDC-1 levels were correlated with disease severity. Patients who died from COVID-19 had greater SDC-1 levels than survivors, and the area under the receiver operating characteristic curve (AUC) analysis suggested the potential of the SDC-1 level as a predictor of mortality (AUC 0.714). K‒M analysis also revealed a significant difference in survival based on an SDC-1 cutoff of 10.65 ng/mL.
CONCLUSIONS: This
study suggested that SDC-1 may serve as a valuable biomarker for assessing COVID-19 severity and predicting mortality within 28 days of hospitalization, particularly in the Japanese population. However, further investigations are required to assess longitudinal changes in SDC-1 levels, validate its predictive value for long-term survival, and consider its applicability to new viral variants.
CONCLUSIONS: SDC-1 is emerging as a potential biomarker for assessing the severity and life expectancy of COVID-19 in the Japanese population, offering promise for improved risk stratification and patient management in the ongoing fight against the virus.