Endotheliopathy is suggested to be an important feature of COVID-19 in hospitalized patients. To determine whether endotheliopathy is involved in COVID-19-associated mortality, markers of endothelial damage were assessed in critically ill COVID-19 patients upon intensive care unit (ICU) admission. Thirty-eight critically ill COVID-19 patients were included in this observational study, 10 of whom died in the ICU. Endothelial biomarkers, including soluble (s)E-selectin, sP-selectin, angiopoietin 1 and 2 (Ang-1 and Ang-2, respectively), soluble intercellular adhesion molecule 1 (sICAM-1), vascular endothelial growth factor (VEGF), soluble vascular endothelial (VE)-cadherin, and von Willebrand factor (vWf), were measured upon ICU admission. The ICU cohort was subsequently divided into survivors and non-survivors; Kaplan–Meier analysis was used to explore associations between biomarkers and survival, while receiver operating characteristic (ROC) curves were generated to determine their potential prognostic value. sE-selectin, sP-selectin, Ang-2, and sICAM-1 were significantly elevated in ICU non-survivors compared to survivors, and also associated with a higher mortality probability in the Kaplan–Meier analysis. The prognostic values of sE-selectin, Ang-2, and sICAM-1 from the generated ROC curves were greater than 0.85. Hence, we conclude that in our cohort, ICU non-survivors had higher levels of specific endothelial markers compared to survivors. Elevated levels of these markers upon ICU admission could possibly predict mortality in COVID-19.

中文翻译：

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ICU 入院时内皮生物标志物水平可作为危重 COVID-19 患者死亡率的预测因子

内皮病变被认为是住院患者中 COVID-19 的一个重要特征。为了确定内皮病是否与 COVID-19 相关死亡率有关，我们对重症监护病房 (ICU) 入住的重症 COVID-19 患者的内皮损伤标志物进行了评估。这项观察性研究纳入了 38 名重症 COVID-19 患者，其中 10 人在 ICU 中死亡。内皮生物标志物，包括可溶性 (s)E-选择素、sP-选择素、血管生成素 1 和 2（分别为 Ang-1 和 Ang-2）、可溶性细胞间粘附分子 1 (sICAM-1)、血管内皮生长因子 (VEGF) 、可溶性血管内皮 (VE)-钙粘蛋白和血管性血友病因子 (vWf) 在入住 ICU 时进行测量。ICU 队列随后被分为幸存者和非幸存者；Kaplan-Meier 分析用于探索生物标志物与生存之间的关联，同时生成受试者工作特征 (ROC) 曲线以确定其潜在的预后价值。与幸存者相比，ICU 非幸存者中的 sE-选择素、sP-选择素、Ang-2 和 sICAM-1 显着升高，并且在 Kaplan-Meier 分析中也与较高的死亡率相关。生成的 ROC 曲线中 sE-选择素、Ang-2 和 sICAM-1 的预后值大于 0.85。因此，我们得出的结论是，在我们的队列中，ICU 非幸存者与幸存者相比具有更高水平的特定内皮标记物。入住 ICU 后这些标记物水平升高可能可以预测 COVID-19 的死亡率。