Vascular Endothelial Damage: The Role of Syndecan-1 and Hyaluronan as Severity Indicators in COVID-19

SARS-CoV-2 was firstly found in bronchoalveloar lavage (BAL) of three suspected COVID-19 patients at Jinyintan Hospital, Wuhan, Hubei Province, China. The cases are still raisingwith2,12% global mortality rate. Hypoxic respiratory failure due to acute distress syndrome (ARDS) is the main cause death. Endothelial cell damage has an important role pathogenesis ARDS and multi-organ dysfuntion patients. endothelium protected by mural cells, which keep vascular integrity. Inflammation prevented these cells inhibiting interaction immune platelets with endothelial cells. These also prevent coagulation producing glycocalyx, inhibitors, blood-clotting enzyme. Vascular glycocalyx maintain function disrupted systemically elderly various comorbidities, can be a probable mechanism for serious complications COVID-19. Glycocalyx disruption severe critical causes increased levels its components such assyndecan-1 hyaluronan serum. Previous studies showed significant increase ofsyndecan-1 septic, Kawasaki dengue biomarkers markers organ damage. Therefore, syndecan-1can prognostic factors morbidity survival