Department of General Pathology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Arkońska 4 Street, 71-455 Szczecin, Poland.
Int J Mol Sci. 2023 Nov 30;24(23):17003. doi: 10.3390/ijms242317003.
The pathophysiology of the severe course of COVID-19 is multifactorial and not entirely elucidated. However, it is well known that the hyperinflammatory response and cytokine storm are paramount events leading to further complications. In this paper, we investigated the vascular response in the pathophysiology of severe COVID-19 and aimed to identify novel biomarkers predictive of ICU admission. The study group consisted of 210 patients diagnosed with COVID-19 (age range: 18-93; mean ± SD: 57.78 ± 14.16), while the control group consisted of 80 healthy individuals. We assessed the plasma concentrations of various vascular factors using the Luminex technique. Then, we isolated RNA from blood mononuclear cells and performed a bioinformatics analysis investigating various processes related to vascular response, inflammation and angiogenesis. Our results confirmed that severe COVID-19 is associated with vWF/ADAMTS 13 imbalance. High plasma concentrations of VEGFR and low DPP-IV may be potential predictors of ICU admission. SARS-CoV-2 infection impairs angiogenesis, hinders the generation of nitric oxide, and thus impedes vasodilation. The hypercoagulable state develops mainly in the early stages of the disease, which may contribute to the well-established complications of COVID-19.
严重 COVID-19 病程的病理生理学是多因素的,尚未完全阐明。然而,众所周知,过度炎症反应和细胞因子风暴是导致进一步并发症的主要事件。在本文中,我们研究了严重 COVID-19 病理生理学中的血管反应,并旨在确定预测 ICU 入院的新型生物标志物。研究组包括 210 名确诊为 COVID-19 的患者(年龄范围:18-93;平均 ± 标准差:57.78 ± 14.16),对照组包括 80 名健康个体。我们使用 Luminex 技术评估了各种血管因子的血浆浓度。然后,我们从血液单核细胞中分离 RNA,并进行了生物信息学分析,研究了与血管反应、炎症和血管生成相关的各种过程。我们的结果证实,严重 COVID-19 与 vWF/ADAMTS13 失衡有关。高血浆浓度的 VEGFR 和低 DPP-IV 可能是 ICU 入院的潜在预测因子。SARS-CoV-2 感染会损害血管生成,阻碍一氧化氮的产生,从而阻碍血管扩张。高凝状态主要发生在疾病的早期阶段,这可能导致 COVID-19 已确立的并发症。