Endothelial glycocalyx shedding during active COVID-19 infection and its effect on disease severity

Figures & data

Table 1. Comparison between the two studied groups according to demographic data, comorbidities, mean oxygen saturation on day 1, the needs for mechanical ventilation, mortality, length of hospital stay and ICU stay.

	Group I (n = 22)	Group II (n = 18)	Test of Sig.	p
Age (years)
Mean ± SD.	58.8 ± 14.6	65.8 ± 14.8	t=1.503	0.141
Sex
Male	12 (54.5%)	7 (38.9%)	χ^2=0.973	0.324
Female	10 (45.5%)	11 (61.1%)
Weight (kg)
Mean ± SD.	90 ± 9.90	86.9 ± 10.5	t=0.944	0.351
Comorbidities	20 (90.9%)	15 (83.3%)	χ^2 = 0.519	^FEp = 0.642
Hypertension	15 (68.2%)	10 (55.6%)	χ^2 = 0.673	0.412
Diabetes	9 (40.9%)	7 (38.9%)	χ^2 = 0.017	0.897
Cardiac	4 (18.2%)	2 (11.1%)	χ^2 = 0.388	^FEp = 0.673
Respiratory	1 (4.5%)	3 (16.7%)	χ^2 = 1.616	^FEp = 0.310
CKD	2 (9.1%)	1 (5.6%)	χ^2 = 0.178	^FEp = 1.000
Cancer	3 (13.6%)	2 (11.1%)	χ^2 = 0.058	^FEp = 1.000
Collagen	2 (9.1%)	2 (11.1%)	χ^2 = 0.045	^FEp = 1.000
Others	2 (9.1%)	7 (38.9%)	χ^2 = 5.041	^FEp = 0.053
Oxygen saturation at room air % on day 1
Mean ± SD.	93.95 ± 2.38	81.1 ± 6.13	t= 8.422*	<0.001*
Needs for MV during hospitalization	5 (22.7%)	8 (44.4%)	χ^2 = 2.128	0.145
Needs for MV in first week	2 (9.1%)	3 (16.7%)	χ^2 = 0.519	^FEp = 0.642
Hospital stay (days)
Mean ± SD.	12.2 ± 4.32	16.5 ± 6.21	U=111.5*	0.017*
Length of ICU stay (days)
Mean ± SD.	9.32 ± 4.36	15.7 ± 6.21	U=77.0*	0.001*
Mortality
No	17 (77.3%)	10 (55.6%)	χ^2=2.128	0.145
Yes	5 (22.7%)	8 (44.4%)

SD: standard deviation;U: Mann–Whitney test; t: Student t-test.

χ²: Chi square test; FE: Fisher Exact.

p: p value for comparing between the two studied groups.

*:Statistically significant at p ≤ 0.05.

Group I: Patients with moderate symptoms.

Group II: Patients with severe symptom.

Table 2. Comparison between the two studied groups according to plasma level of Syndecan-1, Heparan sulfate, D-dimer, Interleukin-6, Procalcitonin and CRP.

		Group I (n = 22)	Sig.	Group II (n = 18)	Sig.	U	p
Syndecan-1 (ng/ml)	Day 1
	Mean ± SD.	117 ± 54.3		160 ± 69.5		100.0*	0.007*
	Day 7
	Mean ± SD.	98 ± 62	p0=0.012*	133 ± 53.0	p0=0.012*	82.0*	0.001*
Heparan sulfate (ng/ml)	Day 1
	Mean ± SD.	4.68 ± 1.33		6.89 ± 2.81		85.0*	0.002*
	Day 7
	Mean ± SD.	3.31 ± 1.19	p0=<0.001*	5.14 ± 3.71	p0=0.007*	119.0*	0.032*
D-dimer (ug/l)	Day 1
	Mean ± SD.	3402 ± 11241		5930 ± 8856		85.50*	0.002*
	Day 4
	Mean ± SD.	2243 ± 6183	p1=0.024*	3816 ± 5197	p1=0.046*	76.0*	0.001*
	Day 7
	Mean ± SD.	1781 ± 2952	p1<0.001*	3139 ± 4431	p1<0.001*	92.0*	0.003*
Interlukin-6 (pg/ml)	Day 1
	Mean ± SD.	34.8 ± 39.5		90.7 ± 66		93.0*	0.004*
	Day 4
	Mean ± SD.	47.5 ± 60.3	p1=0.007*	139.9 ± 151.5	p1=0.010*	81.0*	0.001*
	Day 7
	Mean ± SD.	29.6 ± 65.9	p1=0.024*	54.7 ± 35	p1=0.020*	79.50*	0.001*
Procalcitonin (ng/ml)	Day 1
	Mean ± SD.	0.181 ± 0.199		0.181 ± 0.176		184.5	0.717
	Day 4
	Mean ± SD.	0.326 ± 0.404	p1>0.05	0.292 ± 0.380	p1=0.677	189.0	0.819
	Day 7
	Mean ± SD.	0.938 ± 1.616	p1>0.05	0.856 ± 0.968	p1=0.001*	154.5	0.240
CRP (mg/l)	Day 1
	Mean ± SD.	38.3 ± 38.6		94.3 ± 81.1		96.5*	0.005*
	Day 4
	Mean ± SD.	36.4 ± 54	p1=0.451	62.4 ± 63.7	p1=0.005*	118.0*	0.030*
	Day 7
	Mean ± SD.	25.7 ± 33	p1=0.002*	44.8 ± 38.9	p1<0.001*	99.5*	0.006*

SD: standard deviation; U: Mann–Whitney test; p: p value for comparing between the two studied groups*: Statistically significant at p ≤ 0.05 p₀: p value for Wilcoxon signed ranks test for comparing between Day 1 and Day 7.

p₁: p value for Post Hoc Test (Dunn’s) for Friedman test for comparing between Day 1 and each other periods.

Figure 1. The comparison between changes in the SDC-1, H.S, CRP, D-dimer, IL-6 and procalcitonin between the two groups.

Table 3. Relation between mortality and different parameters (syndecans-1, heparan sulfate, D-dimer, Interleukin-6, CRP and APACHE II score).

	Mortality		U	P
	No (n = 27)	Yes (n = 13)
Plasma syndecan-1 (ng/ml) Day 1 Mean ± SD.	110.2 ± 35.66	191.0 ± 77.18	49.50*	<0.001*
Day 7 Mean ± SD.	99.0 ± 42.88	145.0 ± 78.81	107.0*	0.049*
Heparan sulfate (ng/ml) Day 1 Mean ± SD.	5.05 ± 1.80	6.98 ± 2.93	100.0*	0.029*
Day 7 Mean ± SD.	3.47 ± 1.51	5.53 ± 4.09	90.50*	0.013*
D-dimer (ug/l)
Day 1
Mean ± SD.	3882 ± 10722	5907 ± 9243	88.0*	0.011*
Day 4
Mean ± SD.	2572 ± 6332	3737 ± 4399	56.0*	<0.001*
Day 7
Mean ± SD.	1461 ± 2780	4326 ± 4673	50.0*	<0.001*
Interlukin-6 (pg/ml)
Day 1
Mean ± SD.	35.02 ± 39.23	111.82 ± 61.81	50.0*	<0.001*
Day 4
Mean ± SD.	51.56 ± 57.53	167.02 ± 170.37	72.0*	0.002*
Day 7
Mean ± SD.	18.91 ± 23.90	86.67 ± 72.57	48.0*	<0.001*
CRP (mg/l)
Day 1
Mean ± SD.	52.24 ± 62.89	86.92 ± 71.07	91.50*	0.014*
Day 4
Mean ± SD.	43.72 ± 64.47	57.18 ± 47.57	89.500*	0.012*
Day 7
Mean ± SD.	22.92 ± 31.76	57.90 ± 35.59	44.0*	<0.001*
APACHE II Score
At admission
Mean ± SD.	7.89 ± 3.60	12.08 ± 5.91	98.500*	0.025*
Day 6
Mean ± SD.	4.04 ± 2.67	11.38 ± 6.49	45.500*	<0.001*

SD: standard deviation U: Mann–Whitney test p: p value for comparing between mortality or not.

*Statistically significant at p ≤ 0.05.

Figure 2. The correlation between syndecan-1 and other parameters. It showed a positive correlation with CRP, D-dimer, IL-6, APACHE score and length of hospital stay. SDC-1 was negatively correlated with oxygen saturation.

Figure 3. The correlation between heparan sulfate and other parameters. H.S was positively correlated with D-dimer, IL-6, CRP and length of ICU stay. Also H.S was negatively correlated with oxygen saturation.