Low-Grade Endotoxemia and Thrombosis in COVID-19. Issue 6 (6th June 2021)

• Record Type: Journal Article
• Authors: Oliva, Alessandra; Cammisotto, Vittoria; Cangemi, Roberto; Ferro, Domenico; Miele, Maria Claudia; De Angelis, Massimiliano; Cancelli, Francesca; Pignatelli, Pasquale; Venditti, Mario; Pugliese, Francesco; Mastroianni, Claudio Maria; Violi, Francesco
• Is Part Of: Clinical and translational gastroenterology. Volume 12:Issue 6(2021)
• Page Start: e00348
• Publication Date: 2021-06-06
• Subjects: Stomach -- Diseases -- Periodicals; Intestines -- Diseases -- Periodicals; Gastroenterology; Gastrointestinal Diseases; Liver Diseases; Intestines -- Diseases; Stomach -- Diseases; Periodical; Periodicals; Fulltext; Internet Resources; Periodicals; Electronic journals; 616.33
• DOI: 10.14309/ctg.0000000000000348
• Languages: English
• ISSNs: 2155-384X

Abstract

Abstract : INTRODUCTION: Patients with community-acquired pneumonia display enhanced levels of lipopolysaccharides (LPS) compared with controls, suggesting that low-grade endotoxemia may be implicated in vascular disturbances. It is unknown whether this occurs in patients with coronavirus 2019 (COVID-19) and its impact on thrombotic complications. METHODS: We measured serum levels of zonulin, a marker of gut permeability, LPS, and D-dimer in 81 patients with COVID-19 and 81 healthy subjects; the occurrence of thrombotic events in COVID-19 during the intrahospital stay was registered. RESULTS: Serum LPS and zonulin were higher in patients with COVID-19 than in control subjects and, in COVID-19, significantly correlated ( R = 0.513; P < 0.001). Among the 81 patients with COVID-19, 11 (14%) experienced thrombotic events in the arterial (n = 5) and venous circulation (n = 6) during a median follow-up of 18 days (interquartile range 11–27 days). A logistic regression analysis showed that LPS ( P = 0.024) and D-dimer ( P = 0.041) independently predicted thrombotic events. DISCUSSION: The study reports that low-grade endotoxemia is detectable in patients with COVID-19 and is associated with thrombotic events. The coexistence of low-grade endotoxemia with enhanced levels of zonulin may suggest enhanced gut permeability as an underlying mechanism.