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Syndecan-1 levels predict septic shock in critically ill patients with COVID-19
Nilcyeli Linhares Aragão1,2, Marza de Sousa Zaranza1,2, Gdayllon Cavalcante Meneses1
1Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará. Fortaleza, Ceará, Brazil.
Insights
Syndecan-1 levels can predict septic shock in critically ill COVID-19 patients. Higher admission levels of syndecan-1 (SDC-1) indicate a greater need for vasopressors, aiding in early risk assessment.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Biomarker Research
Background:
- COVID-19-associated sepsis presents similarly to sepsis from other causes.
- Identifying predictors for septic shock in COVID-19 is crucial for patient outcomes.
Purpose of the Study:
- To investigate the predictive role of syndecan-1 (SDC-1) for septic shock in critically ill COVID-19 patients.
- To analyze vascular biomarkers in relation to vasopressor requirement.
Main Methods:
- Prospective study of 86 critically ill COVID-19 patients.
- Quantification of vascular biomarkers including SDC-1 upon admission.
- Association of biomarkers with vasopressor need within 7 days.
Main Results:
- Patients requiring vasopressors showed higher D-dimer and lactate dehydrogenase levels.
- Higher mortality was observed in patients needing vasoactive amines within 24 hours.
- Admission SDC-1 levels >269 ng/ml predicted the need for vasopressors (p=0.024).
Conclusions:
- Syndecan-1 is an independent predictor of septic shock in critically ill COVID-19 patients.
- Elevated SDC-1 levels at admission can identify patients at risk for developing septic shock.
Background:
The clinical picture of coronavirus disease 2019 (COVID-19)-associated sepsis is similar to that of sepsis of other aetiologies. The present study aims to analyse the role of syndecan-1 (SDC-1) as a potential predictor of septic shock in critically ill patients with COVID-19.
Methods:
This is a prospective study of 86 critically ill patients due to COVID-19 infection. Patients were followed until day 28 of hospitalization. Vascular biomarkers, such as vascular cell adhesion protein-1, SDC-1, angiopoietin-1 and angiopoietin-2, were quantified upon admission and associated with the need for vasopressors in the first 7 d of hospitalization.
Results:
A total of 86 patients with COVID-19 (mean age 60±16 y; 51 men [59%]) were evaluated. Thirty-six (42%) patients died during hospitalization and 50 (58%) survived. The group receiving vasopressors had higher levels of D-dimer (2.46 ng/ml [interquartile range {IQR} 0.6-6.1] vs 1.01 ng/ml [IQR 0.62-2.6], p=0.019) and lactate dehydrogenase (929±382 U/l vs 766±312 U/l, p=0.048). The frequency of deaths during hospitalization was higher in the group that received vasoactive amines in the first 24 h in the intensive care unit (70% vs 30%, p=0.002). SDC-1 levels were independently associated with the need for vasoactive amines, and admission values >269 ng/ml (95% CI 0.524 to 0.758, p=0.024) were able to predict the need for vasopressors during the 7 d following admission.
Conclusions:
Syndecan-1 levels predict septic shock in critically ill patients with COVID-19.
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