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长期新冠患者的持续性肺内皮损伤与弥散功能受损

Persistent Endothelial Lung Damage and Impaired Diffusion Capacity in Long COVID.

作者信息

Asimakos Andreas T, Vassiliou Alice G, Keskinidou Chrysi, Spetsioti Stavroula, Antonoglou Archontoula, Vrettou Charikleia S, Mourelatos Panagiotis, Diamantopoulos Aristidis, Pratikaki Maria, Athanasiou Nikolaos, Jahaj Edison, Gallos Parisis, Kotanidou Anastasia, Dimopoulou Ioanna, Orfanos Stylianos E, Katsaounou Paraskevi

机构信息

First Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Evangelismos Hospital, 106 76 Athens, Greece.

Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, 106 76 Athens, Greece.

出版信息

J Pers Med. 2023 Aug 31;13(9):1351. doi: 10.3390/jpm13091351.

Abstract

Since the beginning of the pandemic, both COVID-19-associated coagulopathy biomarkers and a plethora of endothelial biomarkers have been proposed and tested as prognostic tools of severity and mortality prediction. As the pandemic is gradually being controlled, attention is now focusing on the long-term sequelae of COVID-19. In the present study, we investigated the role of endothelial activation/dysfunction in long COVID syndrome. This observational study included 68 consecutive long COVID patients and a healthy age and sex-matched control group. In both groups, we measured 13 endothelial biomarkers. Moreover, in the long COVID patients, we evaluated fatigue and dyspnea severity, lung diffusion capacity (DLCO), and the 6-min walk (6MWT) test as measures of functional capacity. Our results showed that markers of endothelial activation/dysfunction were higher in long COVID patients, and that soluble intracellular adhesion molecule 1 (sICAM-1) and soluble vascular adhesion molecule 1 (sVCAM-1) negatively correlated with lung diffusion and functional capacity (sICAM-1 vs. DLCO, r = -0.306, = 0.018; vs. 6MWT, r = -0.263, = 0.044; and sVCAM-1 vs. DLCO, r= -0.346, = 0.008; vs. 6MWT, r = -0.504, < 0.0001). In conclusion, evaluating endothelial biomarkers alongside clinical tests might yield more specific insights into the pathophysiological mechanisms of long COVID manifestations.

摘要

自大流行开始以来,与新冠病毒相关的凝血病生物标志物以及大量内皮生物标志物已被提出并作为严重程度和死亡率预测的预后工具进行测试。随着大流行逐渐得到控制,现在注意力正集中在新冠病毒的长期后遗症上。在本研究中,我们调查了内皮激活/功能障碍在新冠后综合征中的作用。这项观察性研究纳入了68例连续的新冠后患者以及一个年龄和性别匹配的健康对照组。在两组中,我们测量了13种内皮生物标志物。此外,在新冠后患者中,我们评估了疲劳和呼吸困难的严重程度、肺弥散功能(DLCO)以及6分钟步行试验(6MWT)作为功能能力的指标。我们的结果表明,新冠后患者中内皮激活/功能障碍的标志物更高,并且可溶性细胞间黏附分子1(sICAM - 1)和可溶性血管黏附分子1(sVCAM - 1)与肺弥散和功能能力呈负相关(sICAM - 1与DLCO,r = -0.306,P = 0.018;与6MWT,r = -0.263,P = 0.044;以及sVCAM - 1与DLCO,r = -0.346,P = 0.008;与6MWT,r = -0.504,P < 0.0001)。总之,在临床测试的同时评估内皮生物标志物可能会对新冠后表现的病理生理机制产生更具体的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2544/10533128/608230e788ae/jpm-13-01351-g001.jpg

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