Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil.
Instituto José Frota (IJF) Hospital, Fortaleza, Brazil.
Kidney Blood Press Res. 2024;49(1):27-37. doi: 10.1159/000535035. Epub 2023 Nov 28.
The aim of this was to evaluate the function of vascular biomarkers to predict the need for hemodialysis in critically ill patients with COVID-19.
This is a prospective study with 58 critically ill patients due to COVID-19 infection. Laboratory tests in general and vascular biomarkers, such as VCAM-1, syndecan-1, angiopoietin-1, and angiopoietin-2, were quantified on intensive care unit (ICU) admission.
There was a 40% death rate. VCAM and Ang-2/Ang-1 ratio on ICU admission were associated with the need for hemodialysis. Vascular biomarkers (VCAM-1, syndecan-1, angiopoietin-2/angiopoietin-1 ratio) were predictors of death and their cutoff values were useful to stratify patients with a worse prognosis. In the multivariate cox regression analysis with adjusted models, VCAM-1 (OR 1.13 [CI 95%: 1.01-1.27]; p = 0.034) and Ang-2/Ang-1 ratio (OR 4.87 [CI 95%: 1.732-13.719]; p = 0.003) were associated with the need for dialysis.
Vascular biomarkers, mostly VCAM-1 and Ang-2/Ang-1 ratio, showed better efficiency to predict the need for hemodialysis in critically ill COVID-19 patients.
本研究旨在评估血管生物标志物在预测 COVID-19 危重症患者需要血液透析中的作用。
这是一项前瞻性研究,纳入了 58 例因 COVID-19 感染而入住重症监护病房(ICU)的危重症患者。在 ICU 入院时,对一般实验室检查和血管生物标志物(如 VCAM-1、 syndecan-1、血管生成素-1 和血管生成素-2)进行定量检测。
患者死亡率为 40%。ICU 入院时的 VCAM 和 Ang-2/Ang-1 比值与血液透析的需求相关。血管生物标志物(VCAM-1、 syndecan-1、血管生成素-2/血管生成素-1 比值)是死亡的预测因子,其截断值可用于对预后较差的患者进行分层。在多变量 COX 回归分析中,调整模型后,VCAM-1(OR 1.13 [95%CI:1.01-1.27];p = 0.034)和 Ang-2/Ang-1 比值(OR 4.87 [95%CI:1.732-13.719];p = 0.003)与血液透析的需求相关。
血管生物标志物,尤其是 VCAM-1 和 Ang-2/Ang-1 比值,在预测 COVID-19 危重症患者血液透析需求方面显示出更好的效率。