Endocan as a marker of endotheliitis in COVID-19 patients: modulation by veno-venous extracorporeal membrane oxygenation, arterial hypertension and previous treatment with renin–angiotensin–aldosterone system inhibitors

• DOI: 10.1007/s00011-024-01964-8
• Publication Date: 2025-01-25T10:36:29Z
• Authors: Marta Reina-Couto; David Alves; Carolina Silva-Pe...; Patrícia Pereira-...; Sandra Martins; João Bessa; Luísa Teixeira-Sa...; Dora Pinho; Manuela Morato; Cláudia Camila Dias; António Sarmento; Margarida Tavares; João T. Guimarães; Roberto Roncon-Al...; José-Artur Paiva; António Albino-Te...; Teresa Sousa

Abstract

Background and aims Endocan has been scarcely explored in COVID-19, especially regarding its modulation by veno-venous extracorporeal membrane oxygenation (VV-ECMO), hypertension or previous renin–angiotensin–aldosterone system (RAAS) inhibitors treatment. We compared endocan and other endotheliitis markers in hospitalized COVID-19 patients and assessed their modulation by VV-ECMO, hypertension and previous RAAS inhibitors treatment.

Material and methods Serum endocan, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin were measured in “severe” (n = 27), “critically ill” (n = 17) and “critically ill on VV-ECMO” (n = 17) COVID-19 patients at admission, days 3–4, 5–8 and weekly thereafter, and in controls (n = 23) at a single time point.

Results Admission endocan and VCAM-1 were increased in all patients, but “critically ill on VV-ECMO” patients had higher endocan and E-Selectin. Endocan remained elevated throughout hospitalization in all groups. “Severe” and “critically ill” hypertensive patients or previously treated with RAAS inhibitors had higher endocan and/or VCAM-1, but in VV-ECMO patients the raised endocan values seemed unrelated with these factors. Among all COVID-19 hypertensive patients, those with previous RAAS inhibitors treatment had higher endocan.

Conclusions In our study, endocan stands out as the best marker of endotheliitis in hospitalized COVID-19 patients, being upregulated by VV-ECMO support, hypertension and previous RAAS inhibitor treatment.