Endocan as a potential marker in diagnosis and predicting disease severity in COVID-19 patients: a promising biomarker for patients with false-negative RT-PCR

Keywords: Biomarker, COVID-19, endocan, reverse transcription polymerase change reaction, SARS-CoV-2

Abstract

Background: Endothelial-specific molecule 1 (endocan) has emerged as an inflammatory biomarker in recent years. The purpose of this study was to investigate the diagnostic value of serum endocan levels in the prediction of COVID-19 disease among patients with a false-negative reverse transcription polymerase change reaction (RT-PCR) test, and also to determine its correlation with the clinical severity of the disease.

Methods: Thirty patients with positive RT-PCR results and 30 with false-negative RT-PCR results, both with suspected COVID-19 in terms of clinical, radiological, and laboratory findings, were included in the study. Thirty healthy controls were also enrolled.

Results: Serum endocan levels were estimated to be 821.8 ± 99.3 pg/mL in COVID-19 RT-PCR (+) patients, 803.9 ± 97.0 pg/mL in RT-PCR false (–) patients with suspected COVID-19, and 382.9 ± 37.5 pg/mL in the control group. No significant difference was observed between RT-PCR (+) and RT-PCR false (–) patients (P = 0.68). However, serum endocan levels differed significantly between patient groups and control group (P < 0.05). With a cut-off value of 444.2 pg/mL serum endocan levels differentiated COVID-19 cases from healthy individuals with 92% sensitivity and 80% specificity. Moreover, a significant positive correlation was observed between serum endocan levels and clinical severity (P < 0.01, r = 0.94).

Conclusions: There is a need for different laboratory markers capable of assisting diagnosis and showing COVID-19 infection in suspected COVID-19 RT-PCR false-negative patients. Endocan levels can be used as an assistant blood test for identifying COVID-19 patients with false-negative RT-PCR tests and in determining the clinical severity of the disease.

Downloads

Download data is not yet available.

References


  1. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr. 2020;63:119–24. doi: 10.3345/cep.2020.00493

  2. Zahorec R, Hulin I, Zahorec P. Rationale use of neutrophil-to-lymphocyte ratio for early diagnosis and stratification of COVID-19. Bratisl Lek Listy. 2020;121:466–70. doi: 10.4149/BLL_2020_077

  3. Rossi GP, Sanga V, Barton M. Potential harmful effects of discontinuing ACE-inhibitors and ARBs in COVID-19 patients. Elife. 2020;9:e57278. doi: 10.7554/eLife.57278

  4. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13. doi: 10.1016/S0140-6736(20)30211-7

  5. Sarrazin S, Adam E, Lyon M, Depontieu F, Motte V, Landolfi C, et al. Endocan or endothelial cell specific molecule-1 (ESM-1): a potential novel endothelial cell marker and a new target for cancer therapy. Biochim Biophys Acta. 2006;1765:25–37. doi: 10.1016/j.bbcan.2005.08.004

  6. Béchard D, Scherpereel A, Hammad H, Gentina T, Tsicopoulos A, Aumercier M, et al. Human endothelial-cell specific molecule-1 binds directly to the integrin CD11a/CD18 (LFA-1) and blocks binding to intercellular adhesion molecule-1. J Immunol. 2001;167:3099–106. doi: 10.4049/jimmunol.167.6.3099

  7. General Directorate of Public Health of the Ministry of Health of the Republic of Turkey. COVID-19 (SARS-CoV-2 infection), adult patient treatment. Available from: https://covid19.saglik.gov.tr/Eklenti/39061/0/COVID-19rehberieriskinhastatedavisipdf.pdf [cited 10 March 2021].

  8. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–42. doi: 10.1001/jama.2020.2648

  9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32–40. doi: 10.1148/radiol.2020200642

  10. Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, et al. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020;92:903–8. doi: 10.1002/jmv.25786

  11. Ferrari D, Motta A, Strollo M, Banfi G, Locatelli M. Routine blood tests as a potential diagnostic tool for COVID-19. Clin Chem Lab Med. 2020;58:1095–9. doi: 10.1515/cclm-2020-0398

  12. American College of Radiology. ACR recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. Available from: https://www.acr.org/Search-Results#q=Statements%2FRecommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection [cited 15 April 2021].

  13. Lee YH, Kim SY, Moon H, Seo JW, Kim DJ, Park SH, et al. Endocan as a marker of microvascular inflammation in kidney transplant recipients. Sci Rep. 2019;9:1854. doi: 10.1038/s41598-018-37975-9

  14. Mertoglu C, Gunay M, Yerligok O. Could endocan, a marker of inflammation and endothelial dysfunction, be a new diagnostic marker for fibromyalgia? Clin Lab. 2018;64:405–10. doi: 10.7754/Clin.Lab.2017.171024

  15. Faruk Ozdemir A, Kemerdere R, Orhan B, Ozturk Emre H, Bercik Inal B, Kayhan A, et al. Serum endocan and preoperative systemic inflammatory markers in patients with epilepsy. Neurochirurgie. 2020;66:29–35. doi: 10.1016/j.neuchi.2019.09.025

  16. Zhao R, Dong S. [Clinical value of serum endocan and procalcitonin in early diagnosis and prognosis evaluation of sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017;29:321–6. doi: 10.3760/cma.j.issn.2095-4352.2017.04.007

  17. Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005;11:875–9. doi: 10.1038/nm1267

  18. Hasan SS, Capstick T, Ahmed R, Kow CS, Mazhar F, Merchant HA, et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis. Expert Rev Respir Med. 2020;14:1149–63. doi: 10.1080/17476348.2020.1804365

  19. Kupeli I, Salcan S, Kuzucu M, Kuyrukluyıldız U. Can endocan be a new biomarker in ventilator-associated pneumonia? Kaohsiung J Med Sci. 2018;34:689–94. doi: 10.1016/j.kjms.2018.07.002

  20. Mangat M, Amalakuhan B, Habib S, Reyes LF, Hinojosa CA, Rodriguez AH, et al. High endocan levels are associated with the need for mechanical ventilation among patients with severe sepsis. Eur Respir J. 2017;50(1):1700013. doi: 10.1183/13993003.00013-2017

  21. Orbegozo D, Rahmania L, Irazabal M, Mendoza M, Annoni F, De Backer D, et al. Endocan as an early biomarker of severity in patients with acute respiratory distress syndrome. Ann Intensive Care. 2017;7:93. doi: 10.1186/s13613-017-0311-4

  22. Medetalibeyoglu A, Emet S, Kose M, Akpinar TS, Senkal N, Catma Y, et al. Serum endocan levels on admission are associated with worse clinical outcomes in COVID-19 patients: a pilot study. Angiology. 2021;72: 187–93. doi: 10.1177/0003319720961267

  23. Klok FA, Kruip M, van der Meer NJM, Arbous MS, Gommers D, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145–7. doi: 10.1016/j.thromres.2020.04.013

  24. De Hous N, Hollering P, Van Looveren R, Tran T, De Roover D, Vercauteren S. Symptomatic arterial thrombosis associated with novel coronavirus disease 2019 (COVID-19): report of two cases. Acta Chir Belg. 2021:1–4. doi: 10.1080/00015458.2021.1911751

  25. Mosevoll KA, Lindås R, Wendelbo O, Bruserud O, Reikvam H. Systemic levels of the endothelium-derived soluble adhesion molecules endocan and E-selectin in patients with suspected deep vein thrombosis. Springerplus. 2014;3:571. doi: 10.1186/2193-1801-3-571

  26. Sethuraman N, Jeremiah SS, Ryo A. Interpreting diagnostic tests for SARS-CoV-2. JAMA. 2020;323:2249–51. doi: 10.1001/jama.2020.8259

  27. Watson J, Whiting PF, Brush JE. Interpreting a covid-19 test result. BMJ. 2020;369:m1808. doi: 10.1136/bmj.m1808

Published
2022-01-24
How to Cite
Laloglu E., & Alay H. (2022). Endocan as a potential marker in diagnosis and predicting disease severity in COVID-19 patients: a promising biomarker for patients with false-negative RT-PCR. Upsala Journal of Medical Sciences, 127(1). https://doi.org/10.48101/ujms.v127.8211