Serum angiopoietin 1 level in patients with severe COVID-19: An observational study

Abstract

Background: Exocytosis of the endothelial storage granules, Weibel-Palade bodies, upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion with the consequent release of P-selectin and Von Willebrand factor, as well as several chemokines, results in hypercoagulability. Angiopoietin-2 is a chemokine stored in Weibel-Palade bodies; it is a context-dependent competitive antagonist of angiopoietin-1. Disruption of the angiopoietin/Tie2 pathway contributes to vascular dyshomeostasis in sepsis. This study aimed to investigate serum levels of angiopoietin-1 in patients with severe coronavirus disease 2019 (COVID-19). Methods: A total of 85 participants were enrolled in the study and divided into two groups: the first group included 45 patients with severe COVID-19, and the second group included 40 healthy individuals of comparable age and sex to serve as the control group. ELISA was used to measure serum angiopoietin-1 levels. Results: Serum angiopoietin-1 levels were significantly lower in patients with severe COVID-19 than in control subjects (14.52 (5.56) ng/ml and 30.56 (17.56) ng/ml, respectively; p < 0.001). Moreover, at a cut-off value ≤21.05 ng/ml, serum angiopoietin-1 level had 97.8% sensitivity and 100% specificity in differentiating between severe COVID-19 patients and non-infected individuals (p-value <0.001). Conclusions: Serum angiopoietin-1 levels were lower in patients with severe COVID-19 than in control subjects, and it has potential to be used as a diagnostic marker for patients with severe COVID-19.