Oliva Alessandra, Rando Emanuele, Al Ismail Dania, De Angelis Massimiliano, Cancelli Francesca, Miele Maria Claudia, Aronica Raissa, Mauro Vera, Di Timoteo Federica, Loffredo Lorenzo, Mastroianni Claudio M
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Sapienza School for Advanced Studies (SSAS), Sapienza University of Rome, Viale Regina Elena, 291, 00161 Rome, Italy.
J Clin Med. 2021 Sep 6;10(17):4018. doi: 10.3390/jcm10174018.
E-selectin is a recognized marker of endothelial activation; however, its place in Coronavirus Disease 2019 (COVID-19) has not been fully explored. Aims of the study are to compare sE-selectin values among the Intensive Care Unit (ICU)-admitted and non-admitted, survived and non-survived patients and those with or without thrombosis.
A single-center study of patients with COVID-19 hospitalized at Policlinico Umberto I (Rome) from March to May 2020 was performed. Simple and multiple logistic regression models were developed.
One hundred patients were included, with a median age (IQR) of 65 years (58-78). Twenty-nine (29%) were admitted to ICU, twenty-eight (28%) died and nineteen (19%) had a thrombotic event. The median value (IQR) of sE-selectin was 26.1 ng/mL (18.1-35). sE-selectin values did not differ between deceased and survivors ( = 0.06) and among patients with or without a thrombotic event ( = 0.22). Compared with patients who did not receive ICU treatments, patients requiring ICU care had higher levels of sE-selectin (36.6 vs. 24.1 ng/mL; < 0.001). In the multiple logistic regression model, sE-selectin levels > 33 ng/mL, PaO/FiO < 200 and PaO/FiO 200-300 were significantly associated with an increased risk of ICU admission. sE-selectin values significantly correlated with a neutrophil count (R = 0.32 ( = 0.001)) and the number of days from the symptoms onset to hospitalization (R = 0.28 ( = 0.004)).
sE-selectin levels are predictive of ICU admission in COVID-19 patients. Since data on the relation between sE-selectin and COVID-19 are scarce, this study aims to contribute toward the comprehension of the pathogenic aspects of COVID-19 disease, giving a possible clinical marker able to predict its severity.
E选择素是一种公认的内皮细胞活化标志物；然而，其在2019冠状病毒病（COVID-19）中的作用尚未得到充分研究。本研究的目的是比较入住重症监护病房（ICU）和未入住ICU的患者、存活和未存活的患者以及有或无血栓形成的患者的可溶性E选择素（sE-selectin）值。
对2020年3月至5月在罗马翁贝托一世综合医院住院的COVID-19患者进行了一项单中心研究。建立了简单和多元逻辑回归模型。
纳入100例患者，中位年龄（四分位间距）为65岁（58-78岁）。29例（29%）入住ICU，28例（28%）死亡；19例（19%）发生血栓事件。sE选择素的中位值（四分位间距）为26.1 ng/mL（18.1-35）。死亡患者和存活患者之间以及有或无血栓事件的患者之间的sE选择素值无差异（P = 0.06）和（P = 0.22）。与未接受ICU治疗的患者相比，需要ICU护理的患者sE选择素水平更高（36.6对24.1 ng/mL；P < 0.001）。在多元逻辑回归模型中，sE选择素水平>33 ng/mL、动脉血氧分压/吸入氧分数（PaO₂/FiO₂）<200和PaO₂/FiO₂为200-300与入住ICU的风险增加显著相关。sE选择素值与中性粒细胞计数显著相关（R = 0.32，P = 0.001）以及从症状发作到住院的天数显著相关（R = 0.28，P = 0.004）。
sE选择素水平可预测COVID-19患者入住ICU的情况。由于关于sE选择素与COVID-19之间关系的数据很少，本研究旨在有助于理解COVID-19疾病的致病方面，提供一种可能能够预测其严重程度的临床标志物。
