Background We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality. Methods The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed. Results The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan–Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors. Conclusions COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s10020-021-00412-1.
【저자키워드】 COVID-19, outcome, Syndecan-1, Endothelial glycocalyx, Degradation, 【초록키워드】 coronavirus disease, Inflammation, Tumor, Coronavirus disease 2019, Biomarker, Mortality, intensive care, thrombomodulin, feasibility, Variation, intensive care unit, interleukin-6, endothelial damage, progression, ICU, Coagulopathy, serum, survival, interleukin, tumor necrosis factor, Survivors, severity of COVID-19, glycocalyx, Wuhan, Patient, syndecan, Syndecan-1, demographic, COVID-19 patients, association, marker, survival analysis, Potential treatment, COVID-19 patient, tumor necrosis, tumor necrosis factor-α, supplementary material, laboratory data, log-rank test, Kaplan–Meier survival analysis, increased mortality, survivor, destruction, inflammatory reactions, non-survivor, Wuhan, China, Result, greater, analyzed, develop, examined, indicated, investigated, median, significantly higher, two group, not significantly different, Protecting, 【제목키워드】 ICU, Patient, predict, endothelial, with COVID-19,