Systemic vascular damage with micro/macro-thrombosis is a typical feature of severe COVID-19. However, the pathogenesis of this damage and its predictive biomarkers remain poorly defined. For this reason, in this study, serum monocyte chemotactic protein (MCP)-2 and P- and E-selectin levels were analyzed in 204 patients with COVID-19. Serum MCP-2 and P-selectin were significantly higher in hospitalized patients compared with asymptomatic patients. Furthermore, MCP-2 increased with the WHO stage in hospitalized patients. After 1 week of hospitalization, MCP-2 levels were significantly reduced, while P-selectin increased in patients in WHO stage 3 and decreased in patients in WHO stages 5–7. Serum E-selectin was not significantly different between asymptomatic and hospitalized patients. The lower MCP-2 levels after 1 week suggest that endothelial damage triggered by monocytes occurs early in COVID-19 disease progression. MCP-2 may also predict COVID-19 severity. The increase in P-selectin levels, which further increased in mild patients and reduced in severe patients after 1 week of hospitalization, suggests that the inactive form of the protein produced by the cleavage of the active protein from the platelet membrane is present. This may be used to identify a subset of patients that would benefit from targeted therapies. The unchanged levels of E-selectin in these patients suggest that endothelial damage is less relevant.

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有关 COVID-19 患者内皮损伤的进一步发现


伴有微/大血栓形成的全身血管损伤是严重 COVID-19 的典型特征。然而，这种损伤的发病机制及其预测生物标志物仍不清楚。为此，本研究对 204 名 COVID-19 患者的血清单核细胞趋化蛋白 (MCP)-2 以及 P-和 E-选择素水平进行了分析。住院患者血清MCP-2和P-选择素显着高于无症状患者。此外，住院患者中MCP-2随着WHO分期的增加而增加。住院1周后，WHO 3期患者中MCP-2水平显着降低，而P-选择素升高，WHO 5-7期患者中P-选择素降低。无症状患者和住院患者之间的血清E-选择素没有显着差异。 1 周后较低的 MCP-2 水平表明单核细胞引发的内皮损伤发生在 COVID-19 疾病进展的早期。 MCP-2 还可以预测 COVID-19 的严重程度。住院 1 周后，P-选择素水平在轻度患者中进一步升高，在重症患者中降低，表明存在活性蛋白从血小板膜裂解产生的非活性形式。这可用于识别将从靶向治疗中受益的患者子集。这些患者中 E-选择素水平未发生变化，表明内皮损伤的相关性较小。