BACKGROUND: Coronavirus disease (COVID-19) associated endotheliopathy and microvascular dysfunction are of concern. OBJECTIVE: The objective of the present single-center observational pilot study was to compare endothelial glycocalyx (EG) damage and endotheliopathy in patients with severe COVID-19 (COVID-19 group) with patients with bacterial pneumonia with septic shock (non-COVID group). METHODS: Biomarkers of EG damage (syndecan-1), endothelial cells (EC) damage (thrombomodulin), and activation (P-selectin) were measured in blood on three consecutive days from admission to the intensive care unit (ICU). The sublingual microcirculation was studied by Side-stream Dark Field (SDF) imaging with automatic assessment. RESULTS: We enrolled 13 patients in the non-COVID group (mean age 70 years, 6 women), and 15 in the COVID-19 group (64 years old, 3 women). The plasma concentrations of syndecan-1 were significantly higher in the COVID-19 group during all three days. Differences regarding other biomarkers were not statistically significant. The assessment of the sublingual microcirculation showed improvement on Day 2 in the COVID-19 group. Plasma levels of C-reactive protein (CRP) were significantly higher on the first two days in the COVID-19 group. Plasma syndecan-1 and CRP were higher in patients suffering from severe COVID-19 pneumonia compared to bacterial pneumonia patients. CONCLUSIONS: These findings support the role of EG injury in the microvascular dysfunction in COVID-19 patients who require ICU.

1st Department of Anaesthesia and Intensive Therapy Medical University of Lublin Lublin Poland

Center for Research and Development University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Anaesthesia Pain Management and Perioperative Medicine Dalhousie University Halifax NS Canada

Department of Anesthesiology Perioperative Medicine and Intensive Care J E Purkinje University Masaryk Hospital Usti nad Labem Czech Republic

Department of Anesthesiology Resuscitation and Intensive Care Medicine University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Clinical Biochemistry and Diagnostics University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Microbiology and Immunology Dalhousie University Halifax NS Canada

Department of Pharmacology Dalhousie University Halifax NS Canada

Department of Physiology and Biophysics Dalhousie University Halifax NS Canada

Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

International Fluid Academy Lovenjoel Belgium

Karolinska Institutet at Danderyds Hospital Stockholm Sweden

Research Unit Södertälje Hospital Södertälje Sweden

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