The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant global morbidity and mortality. This study aimed to investigate the clinical significance of serum vascular endothelial growth factor A (VEGF-A) in COVID-19 patients and its association with disease severity and pulmonary injury. We prospectively collected data from 71 hospitalized COVID-19 patients between June 2020 and January 2021. Patients were classified as either mild or severe based on their oxygen requirements during hospitalization. Serum VEGF-A levels were measured using an ELISA kit. In comparison to mild cases, significantly elevated serum VEGF-A levels were observed in severe COVID-19 patients. Furthermore, VEGF-A levels exhibited a positive correlation with white blood cell count, neutrophil count, and lymphocyte count. Notably, serum surfactant protein-D (SP-D), an indicator of alveolar epithelial cell damage, was significantly higher in patients with elevated VEGF-A levels. These results suggest that elevated serum VEGF-A levels could serve as a prognostic biomarker for COVID-19 as it is indicative of alveolar epithelial cell injury caused by SARS-CoV-2 infection. Additionally, we observed a correlation between VEGF-A and neutrophil activation, which plays a role in the immune response during endothelial cell injury, indicating a potential involvement of angiogenesis in disease progression. Further research is needed to elucidate the underlying mechanisms of VEGF-A elevation in COVID-19.

中文翻译：

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COVID-19 患者入院时的血清 VEGF-A 水平与 SP-D 和中性粒细胞相关，反映疾病严重程度：一项前瞻性研究

由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的 2019 年冠状病毒病 (COVID-19) 大流行导致了全球显着的发病率和死亡率。本研究旨在探讨COVID-19患者血清血管内皮生长因子A（VEGF-A）的临床意义及其与疾病严重程度和肺损伤的关系。我们前瞻性地收集了 2020 年 6 月至 2021 年 1 月期间 71 名住院的 COVID-19 患者的数据。根据患者住院期间的氧气需求，将患者分为轻度或重度。使用 ELISA 试剂盒测量血清 VEGF-A 水平。与轻症病例相比，重症 COVID-19 患者的血清 VEGF-A 水平显着升高。此外，VEGF-A水平与白细胞计数、中性粒细胞计数和淋巴细胞计数呈正相关。值得注意的是，血清表面活性蛋白-D (SP-D)（肺泡上皮细胞损伤的指标）在 VEGF-A 水平升高的患者中显着升高。这些结果表明，血清 VEGF-A 水平升高可以作为 COVID-19 的预后生物标志物，因为它表明 SARS-CoV-2 感染引起的肺泡上皮细胞损伤。此外，我们观察到 VEGF-A 和中性粒细胞活化之间的相关性，中性粒细胞活化在内皮细胞损伤期间的免疫反应中发挥作用，表明血管生成可能参与疾病进展。需要进一步研究来阐明 COVID-19 中 VEGF-A 升高的潜在机制。