Potential value of circulating endothelial cells for the diagnosis and treatment of COVID-19

Xuchang Zhang,Man Jiang,Jianshe Yang

doi:10.1016/j.ijid.2021.05.001

Abstract

The ongoing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has been a formidable global challenge. As yet, there are very few drugs to treat this infection and no vaccine is currently available. It has gradually become apparant that coronavirus disease 2019 (COVID-19) is not a simple disease involving a single organ; rather, many vital organs and systems are affected. The endothelium is one target of SARS-CoV-2. Damaged endothelial cells, which break away from organs and enter the bloodstream to form circulating endothelial cells, were recently reported as putative biomarkers for COVID-19. Modulation of the expression level of sphingosine-1 phosphate via sphingosine kinase activation can control endothelial cell proliferation and apoptosis. As such, it may be possible to obtain a sensitive and specific diagnosis of the severity of COVID-19 by assessing the absolute number and the viable/apoptotic ratio of circulating endothelial cells. Furthermore, a focus on the endothelium could help to develop a strategy for COVID-19 treatment from the perspective of endothelial protection and repair.

Highlights

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread throughout the world
The circulating endothelial cells (CECs) levels in patients with COVID-19 who required intensive care unit (ICU) treatment were significantly higher compared with patients who did not need ICU treatment
The study found a strong relationship between disease severity and the extent of endothelial injury; as such, the CEC level was postulated as a putative biomarker for the severity of COVID-19

Summary

Introduction

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread throughout the world. At the onset of the pandemic, COVID-19 was considered to be a mono-organ disease involving lesions; the pulmonary system, gastrointestinal system, kidney, heart and liver have been identified as targets of SARS-CoV-2 infection (Cheung et al, 2020; Puelles et al, 2020). A recent study (Guervilly et al, 2020) identified a possible correlation between increased levels of circulating endothelial cells (CECs), which are the deciduous endothelial cells from the injured organs or tissues circulating in blood, and the severity of COVID-19.

Results

Conclusion