key: cord-0709835-c7tj94wy
authors: Honore, Patrick M.; Redant, Sebastien; Preseau, Thierry; Cismas, Bogdan Vasile; Kaefer, Keitiane; Barreto Gutierrez, Leonel; Anane, Sami; Attou, Rachid; Gallerani, Andrea; De Bels, David
title: Is endocan correlated to ARDS severity or an epiphenomenon of thrombo-embolic disease in COVID
date: 2021-12-14
journal: Crit Care
DOI: 10.1186/s13054-021-03850-9
sha: 95023b08d41c56ccba6e02b71dfcfbcb85463e3f
doc_id: 709835
cord_uid: c7tj94wy

nan

With great interest, we read the recently published paper by Pascreau et al. concluding that a high blood endocan profile during COVID-19 distinguishes moderate from severe acute respiratory distress syndrome (ARDS) [1] . In a recent study including 46 patients with a diagnosis of pulmonary thromboembolism (PTE) and a control group of 25 healthy individuals [2] , there was a significant difference in the serum endocan levels between the patients and the control group (321.93 ng/l and 192.77 ng/l, respectively; p < 0.030) [2] . Endocan is likely a good marker for PTE, a frequent phenomenon in COVID-19 [3] . In a prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated deaths, on autopsy (n = 283) it was found that the majority died of pneumonia and/or diffuse alveolar damage (73.6%) but thromboses were found in 39.2% and PTE in 22.1% [3] . Another study demonstrated significant associations between PTE and not only mechanical ventilation (OR = 3.71, 95% CI 2.57-5.36), but also intensive care unit admission (OR = 2.99, 95% CI 2.11-4.23), circulating D-dimer [mean difference (MD) = 5.04 µg/mL, 95% CI 3.67-6.42) and c-reactive protein (CRP) (MD = 1.97 mg/dL, 95% CI 0.58-3.35) [4] . Those characteristics are similar to those found in the Pascreau study (high CRP, high D-dimers and mechanical ventilation in ARDS COVID patients) [1] . As there is no indication they excluded PTE in their patient cohort, it seems plausible that Pascreau et al. are describing the consequences of thromboses and PTE in ARDS COVID patients [1] . The explanation for endocan levels is therefore more likely to be found here than as a marker of ARDS severity.

Abbreviations ARDS: Acute respiratory distress syndrome; PTE: Pulmonary thromboembolism.

A high blood endocan profile during COVID-19 distinguishes moderate from severe acute respiratory distress syndrome

Evaluation of serum endothelial cell specific molecule-1 (endocan) levels as a biomarker in patients with pulmonary thromboembolism

Prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated death cases

Mortality and risk factors associated with pulmonary embolism in coronavirus disease 2019 patients: a systematic review and meta-analysis

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None. The authors declare to have no competing interests. 1 

Authors' contributions PMH, SM, SR and DDB designed the paper. All authors participated in drafting and reviewing. All authors read and approved the final version of the manuscript.

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*Correspondence: Patrick.Honore@CHU-Brugmann.be