BACKGROUND The clinical picture of coronavirus disease 2019 (COVID-19)-associated sepsis is similar to that of sepsis of other aetiologies. The present study aims to analyse the role of syndecan-1 (SDC-1) as a potential predictor of septic shock in critically ill patients with COVID-19. METHODS This is a prospective study of 86 critically ill patients due to COVID-19 infection. Patients were followed until day 28 of hospitalization. Vascular biomarkers, such as vascular cell adhesion protein-1, SDC-1, angiopoietin-1 and angiopoietin-2, were quantified upon admission and associated with the need for vasopressors in the first 7 d of hospitalization. RESULTS A total of 86 patients with COVID-19 (mean age 60±16 y; 51 men [59%]) were evaluated. Thirty-six (42%) patients died during hospitalization and 50 (58%) survived. The group receiving vasopressors had higher levels of D-dimer (2.46 ng/ml [interquartile range {IQR} 0.6-6.1] vs 1.01 ng/ml [IQR 0.62-2.6], p=0.019) and lactate dehydrogenase (929±382 U/l vs 766±312 U/l, p=0.048). The frequency of deaths during hospitalization was higher in the group that received vasoactive amines in the first 24 h in the intensive care unit (70% vs 30%, p=0.002). SDC-1 levels were independently associated with the need for vasoactive amines, and admission values >269 ng/ml (95% CI 0.524 to 0.758, p=0.024) were able to predict the need for vasopressors during the 7 d following admission. CONCLUSIONS Syndecan-1 levels predict septic shock in critically ill patients with COVID-19.

中文翻译：

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Syndecan-1 水平可预测 COVID-19 危重患者的感染性休克。

背景 2019 年冠状病毒病 (COVID-19) 相关脓毒症的临床表现与其他病因引起的脓毒症相似。本研究旨在分析 syndecan-1 (SDC-1) 作为 COVID-19 危重患者感染性休克潜在预测因子的作用。方法 这是一项对 86 名因 COVID-19 感染而危重的患者进行的前瞻性研究。对患者进行随访直至住院第28天。血管生物标志物，如血管细胞粘附蛋白-1、SDC-1、血管生成素-1和血管生成素-2，在入院时进行量化，并与住院前 7 天是否需要血管加压药相关。结果 总共对 86 名 COVID-19 患者（平均年龄 60±16 岁；51 名男性 [59%]）进行了评估。36 名 (42%) 患者在住院期间死亡，50 名 (58%) 患者幸存。接受血管升压药的组的 D-二聚体水平较高（2.46 ng/ml [四分位数范围 {IQR} 0.6-6.1] vs 1.01 ng/ml [IQR 0.62-2.6]，p=0.019）和乳酸脱氢酶（929±382 U） /l 对比 766±312 U/l，p=0.048）。在重症监护病房的前 24 小时内接受血管活性胺治疗的组中，住院期间的死亡频率较高（70% vs 30%，p=0.002）。SDC-1水平与血管活性胺的需求独立相关，入院值>269 ng/ml（95% CI 0.524至0.758，p = 0.024）能够预测入院后7天内对血管加压药的需求。结论 Syndecan-1 水平可预测 COVID-19 危重患者的感染性休克。