Related Experiment Video
Updated: Sep 28, 2025
In vivo Measurement of the Mouse Pulmonary Endothelial Surface Layer
Published on: February 22, 2013
Endothelial glycocalyx damage in patients with severe COVID-19 on mechanical ventilation - A prospective
David Astapenko1,2,3, Adela Tomasova2,4, Alena Ticha4
1Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
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.
