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Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)

Endothelial insult and damage is one of the reported consequences of SARS-CoV-2 infection. It has been associated with severe inflammation, thrombotic phenomena and profound hypoxemia in critically ill patients. Endothelial activation leads to a loss of the endothelium's antithrombotic properti...

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Autores principales: Fernández-Sarmiento, Jaime, Flórez, Steffanie, Alarcón-Forero, Laura C., Salazar-Peláez, Lina María, Garcia-Casallas, Julio, Mulett, Hernando, Acevedo, Lorena, Salamanca, Carolina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451682/
https://www.ncbi.nlm.nih.gov/pubmed/34552899
http://dx.doi.org/10.3389/fped.2021.726949
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author Fernández-Sarmiento, Jaime
Flórez, Steffanie
Alarcón-Forero, Laura C.
Salazar-Peláez, Lina María
Garcia-Casallas, Julio
Mulett, Hernando
Acevedo, Lorena
Salamanca, Carolina
author_facet Fernández-Sarmiento, Jaime
Flórez, Steffanie
Alarcón-Forero, Laura C.
Salazar-Peláez, Lina María
Garcia-Casallas, Julio
Mulett, Hernando
Acevedo, Lorena
Salamanca, Carolina
author_sort Fernández-Sarmiento, Jaime
collection PubMed
description Endothelial insult and damage is one of the reported consequences of SARS-CoV-2 infection. It has been associated with severe inflammation, thrombotic phenomena and profound hypoxemia in critically ill patients. Endothelial activation leads to a loss of the endothelium's antithrombotic properties which, under normal conditions, are maintained by the endothelial glycocalyx, a carbohydrate-rich layer that covers the luminal surface of endothelial cells. In children, one of the serious forms of SARS-CoV-2 virus disease (COVID-19) is multisystem inflammatory syndrome (MIS-C). This new disease is characterized by a large inflammatory response and frequent cardiovascular, cutaneous and gastrointestinal disorders. We describe the first two cases of critically ill children with MIS-C who evidenced a large inflammatory response associated with elevated plasma and imaging biomarkers of endothelial activation and endothelial glycocalyx degradation. This microcirculation involvement in MIS-C could, at least partially, explain some of the clinical manifestations and laboratory and imaging alterations found in these patients. These findings contribute to a better understanding of this disease and suggest that medications to modulate the inflammatory response and protect or restore the endothelial glycocalyx should be considered in future studies.
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spelling pubmed-84516822021-09-21 Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C) Fernández-Sarmiento, Jaime Flórez, Steffanie Alarcón-Forero, Laura C. Salazar-Peláez, Lina María Garcia-Casallas, Julio Mulett, Hernando Acevedo, Lorena Salamanca, Carolina Front Pediatr Pediatrics Endothelial insult and damage is one of the reported consequences of SARS-CoV-2 infection. It has been associated with severe inflammation, thrombotic phenomena and profound hypoxemia in critically ill patients. Endothelial activation leads to a loss of the endothelium's antithrombotic properties which, under normal conditions, are maintained by the endothelial glycocalyx, a carbohydrate-rich layer that covers the luminal surface of endothelial cells. In children, one of the serious forms of SARS-CoV-2 virus disease (COVID-19) is multisystem inflammatory syndrome (MIS-C). This new disease is characterized by a large inflammatory response and frequent cardiovascular, cutaneous and gastrointestinal disorders. We describe the first two cases of critically ill children with MIS-C who evidenced a large inflammatory response associated with elevated plasma and imaging biomarkers of endothelial activation and endothelial glycocalyx degradation. This microcirculation involvement in MIS-C could, at least partially, explain some of the clinical manifestations and laboratory and imaging alterations found in these patients. These findings contribute to a better understanding of this disease and suggest that medications to modulate the inflammatory response and protect or restore the endothelial glycocalyx should be considered in future studies. Frontiers Media S.A. 2021-09-06 /pmc/articles/PMC8451682/ /pubmed/34552899 http://dx.doi.org/10.3389/fped.2021.726949 Text en Copyright © 2021 Fernández-Sarmiento, Flórez, Alarcón-Forero, Salazar-Peláez, Garcia-Casallas, Mulett, Acevedo and Salamanca. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Fernández-Sarmiento, Jaime
Flórez, Steffanie
Alarcón-Forero, Laura C.
Salazar-Peláez, Lina María
Garcia-Casallas, Julio
Mulett, Hernando
Acevedo, Lorena
Salamanca, Carolina
Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title_full Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title_fullStr Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title_full_unstemmed Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title_short Case Report: Endothelial Glycocalyx Damage in Critically ill Patients With SARS-CoV-2-Related Multisystem Inflammatory Syndrome (MIS-C)
title_sort case report: endothelial glycocalyx damage in critically ill patients with sars-cov-2-related multisystem inflammatory syndrome (mis-c)
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451682/
https://www.ncbi.nlm.nih.gov/pubmed/34552899
http://dx.doi.org/10.3389/fped.2021.726949
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