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Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study

Although coronavirus disease 2019 (COVID-19) is considered a systemic disease associated with vascular inflammation and eventual destruction of the protective endothelial glycocalyx (eGC), biomarkers of eGC damage are not yet available in the clinic. The most prominent components of eGC are sulphate...

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Autores principales: Rovas, Alexandros, Neumann, Julia Katharina, Drost, Carolin Christina, Vollenberg, Richard, Thölking, Gerold, Fobker, Manfred, Witzenrath, Martin, Kümpers, Philipp
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455319/
https://www.ncbi.nlm.nih.gov/pubmed/37629312
http://dx.doi.org/10.3390/jcm12165269
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author Rovas, Alexandros
Neumann, Julia Katharina
Drost, Carolin Christina
Vollenberg, Richard
Thölking, Gerold
Fobker, Manfred
Witzenrath, Martin
Kümpers, Philipp
author_facet Rovas, Alexandros
Neumann, Julia Katharina
Drost, Carolin Christina
Vollenberg, Richard
Thölking, Gerold
Fobker, Manfred
Witzenrath, Martin
Kümpers, Philipp
author_sort Rovas, Alexandros
collection PubMed
description Although coronavirus disease 2019 (COVID-19) is considered a systemic disease associated with vascular inflammation and eventual destruction of the protective endothelial glycocalyx (eGC), biomarkers of eGC damage are not yet available in the clinic. The most prominent components of eGC are sulphated glycosaminoglycans (sGAGs) attached to core proteoglycans. We hypothesised that the amount of sGAG fragments shed in urine (as a surrogate for systemic eGC damage) would correlate with disease severity and outcome. Total urinary sGAG concentration was measured using an in-house optimised 1,9-dimethylmethylene blue (DMMB) assay, which is highly accurate and insensitive to interferences. The median urinary sGAG concentration was significantly higher in 67 hospitalised patients with COVID-19 compared to 72 hospitalised patients with community-acquired pneumonia (CAP). In both groups, urinary sGAG concentrations predicted a combined endpoint (including intubation and death) with an area under the receiver operator characteristic curve of 0.72 (95% CI 0.55–0.88, p = 0.01) and 0.70 (95% CI 0.57–0.83, p = 0.007), respectively. In conclusion, the inexpensive and easy-to-perform DMMB assay provides a surrogate parameter for eGC damage that may be useful for risk stratification of patients with COVID-19 and CAP.
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spelling pubmed-104553192023-08-26 Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study Rovas, Alexandros Neumann, Julia Katharina Drost, Carolin Christina Vollenberg, Richard Thölking, Gerold Fobker, Manfred Witzenrath, Martin Kümpers, Philipp J Clin Med Article Although coronavirus disease 2019 (COVID-19) is considered a systemic disease associated with vascular inflammation and eventual destruction of the protective endothelial glycocalyx (eGC), biomarkers of eGC damage are not yet available in the clinic. The most prominent components of eGC are sulphated glycosaminoglycans (sGAGs) attached to core proteoglycans. We hypothesised that the amount of sGAG fragments shed in urine (as a surrogate for systemic eGC damage) would correlate with disease severity and outcome. Total urinary sGAG concentration was measured using an in-house optimised 1,9-dimethylmethylene blue (DMMB) assay, which is highly accurate and insensitive to interferences. The median urinary sGAG concentration was significantly higher in 67 hospitalised patients with COVID-19 compared to 72 hospitalised patients with community-acquired pneumonia (CAP). In both groups, urinary sGAG concentrations predicted a combined endpoint (including intubation and death) with an area under the receiver operator characteristic curve of 0.72 (95% CI 0.55–0.88, p = 0.01) and 0.70 (95% CI 0.57–0.83, p = 0.007), respectively. In conclusion, the inexpensive and easy-to-perform DMMB assay provides a surrogate parameter for eGC damage that may be useful for risk stratification of patients with COVID-19 and CAP. MDPI 2023-08-13 /pmc/articles/PMC10455319/ /pubmed/37629312 http://dx.doi.org/10.3390/jcm12165269 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rovas, Alexandros
Neumann, Julia Katharina
Drost, Carolin Christina
Vollenberg, Richard
Thölking, Gerold
Fobker, Manfred
Witzenrath, Martin
Kümpers, Philipp
Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title_full Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title_fullStr Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title_full_unstemmed Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title_short Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia—A Proof-of-Concept Study
title_sort analysis of urinary glycosaminoglycans to predict outcome in covid-19 and community-acquired pneumonia—a proof-of-concept study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455319/
https://www.ncbi.nlm.nih.gov/pubmed/37629312
http://dx.doi.org/10.3390/jcm12165269
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