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Endotoxin Activity Assay for the Detection of Whole Blood Endotoxemia in Critically Ill Patients
Published on: June 24, 2019
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Endotoxemia in Critically Ill Patients with COVID-19
Sobia Khan1, Olena Bolotova1, Haseena Sahib1
1Department of Medicine, Stony Brook University, Stony Brook, New York, USA.
Blood Purification
|September 13, 2021
Summary
Elevated endotoxin activity (EA) was common in critically ill COVID-19 patients with multi-organ dysfunction, even without bacterial infection. This elevated EA and nonresponse to EA were linked to acute kidney injury (AKI).
Area of Science:
- Critical care medicine
- Infectious diseases
- Pathophysiology of COVID-19
Background:
- Mechanisms of critical illness in COVID-19 are not fully understood.
- Endotoxemia has been observed in viral infections, but its prevalence in severe COVID-19 requires more study.
Purpose of the Study:
- To investigate the rate and severity of endotoxin activity (EA) in critically ill patients with COVID-19 pneumonia.
- To explore the association between EA levels and organ dysfunction, specifically acute kidney injury (AKI).
Main Methods:
- A single-center, cross-sectional study of 32 intensive care unit patients with COVID-19 pneumonia and multi-organ dysfunction.
- Endotoxin activity (EA) was measured, and patients were categorized by EA levels (low, intermediate, high) or nonresponse (NR).
Main Results:
- A majority of patients (31% intermediate, 44% high EA) exhibited elevated EA, with only 6% having gram-negative bacteremia.
- Nonresponders (NRs) and patients with high EA showed significantly higher rates of acute kidney injury (AKI) compared to those with low/intermediate EA.
Conclusions:
- Elevated EA is prevalent in critically ill COVID-19 patients with multi-organ dysfunction, independent of bacterial infection.
- Elevated EA and NR to EA are associated with AKI, warranting further investigation in larger studies.
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