PB1353 - Endothelial damage in COVID-19: association with disease severity, VTE and mortality.

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Maria Rita Peralta, MD

Haemostasis&Thrombosis Consultant
St Thomas Hospital & Royal Brompton Hospital, London, UK
LONDON, England, United Kingdom

Co-Author(s)

VM

Vincent Muczynski

Research Associate
Research Department of Haematology, University College London (UCL)
London, England, United Kingdom
PL

Philip Lane

Research Scientist
Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
London, England, United Kingdom
AR

Anne Riddell

Laboratory Manager
Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free London NHS Foundation Trust. London, United Kingdom
London, England, United Kingdom
SB

Sanjay Bhagani

Professor in Infectious Disease
Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
London, England, United Kingdom
BA

Banwari Agarwal

Professor of Liver Intensive Care Medicine
Department of Intensive Care, Royal Free London NHS Foundation Trust, London, UK
London, England, United Kingdom

Background: COVID-19 infection primarily affects the pulmonary system, but extensive studies have shown that it also affects the vasculature in the extrapulmonary systems by directly (via virus infection) or indirectly (via cytokine storm), causing endothelial dysfunction and multi-organ injury.

Aims: 1. Identify parameters associated with poor outcomes (VTE, death).
3. Compare endothelial markers changes between ICU-control and severe COVID-19 patients.

Methods: Cross-sectional study, including 151 unvaccinated COVID-19 patients,16 healthy volunteers (HVs) and 10 ICU-control sampled between April 15 and May 31, 2020. 21 endothelial biomarkers were investigated by multiplex assays and statistical analysis (Mann-Whitney u test) performed to characterise the endothelial profile of COVID-19 patients.

Results: By comparing HV to COVID-19 patients: 18 out of 21 biomarkers were higher in the latter group. There was a degree of endothelium damage also in the ambulatory patients compared to HV: 12 biomarkers were higher in the ambulatory compared to HV. However, endothelium impairment was also seen in the ICU-control. No statistical difference was observed for 13 biomarkers.
When comparing survivors to non-survivors TFPI, ICAM-1, LYVE-1, resistin were found to be more elevated in non-survivors compared to survivors (p value ranging from 0.0005 to 0.08), with the remaining endothelium markers showing no significance. In terms of VTE development a higher number of biomarkers were seen to be associated with thrombosis: TFPI, VEGF-A, VEGFR-1, PDGF-BB, syndecan, LYVE-1,follistatin (p - value ranging from < 0.0001 to 0.01).

Conclusion(s): COVID-19 continues to affect populations worldwide. Our results confirm the concept that endothelium damage is implicated in COVID-19 infection. The data show that also in ambulatory patients there are changes in endothelial markers. Endothelium damage is not exclusive of COVID-19 but present in critically ill patients. In the light of the above, treatment of endothelial dysfunction should be pursued to protect vulnerable patients and improve outcomes.