Can Endothelial Surface Markers Predict Vascular Complications And Hypercoagulability In COVID-19?"

Abstract

The vascular manifestations of COVID-19 have emerged as critical contributors to disease morbidity and mortality, particularly through mechanisms involving endothelial dysfunction and hypercoagulability. In this study, we investigated the predictive value of endothelial surface markers—specifically circulating endothelial cells (CECs) and their progenitors—as indicators of vascular injury and disease severity in COVID-19 patients. Using high-precision flow cytometric analysis, we quantified CECs and endothelial progenitor cells (EPCs) in peripheral blood samples from patients across varying degrees of COVID-19 severity.Our findings demonstrate a statistically significant elevation of both CECs and EPCs in patients with confirmed COVID-19 compared to healthy controls. Moreover, these elevations correlated strongly with clinical markers of hypercoagulability, such as elevated D-dimer levels and thrombotic events, underscoring the central role of endothelial perturbation in the pathophysiology of SARS-CoV-2 infection. Notably, we utilized these endothelial biomarkers to stratify disease severity, revealing their potential as quantitative tools for clinical triage and prognostication.Given the annual recurrence of COVID-19 during winter seasons and its increasingly indistinct clinical profile from other upper respiratory tract infections (URTIs), the need for precise, biomarker-driven diagnostic and prognostic tools has become more urgent. Our study supports the implementation of CEC and EPC profiling as a standardized approach for early vascular assessment in COVID-19, offering a refined lens through which to distinguish and manage cases with potential for severe vascular complications.