ArticlePloS one2021
Dexamethasone may improve severe COVID-19 via ameliorating endothelial injury and inflammation: A preliminary pilot study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Endotheliopathy in Acute COVID-19 and Long COVID.International journal of molecular sciences · 2023Pooled it
- RAGE has potential pathogenetic and prognostic value in nonintubated hospitalized patients with COVID-19.JCI insight · 2022Trial
- Research progress on biomarkers of blast lung injury: Transition from traditional indicators to novel molecular markers.iScience · 2026Review
- Observational
- Inflammatory, fibrotic and endothelial biomarker profiles in COVID-19 patients during and following hospitalization.Scientific reports · 2025Article
- Prevalence of thromboembolic events in critically-ill COVID-19 patients infected with Omicron: results from the French prospective, multicenter SEVARVIR cohort study.Critical care (London, England) · 2025Article
- COVID-19-Associated Sepsis: Potential Role of Phytochemicals as Functional Foods and Nutraceuticals.International journal of molecular sciences · 2024Review
- Protecting the endothelial glycocalyx in COVID-19.PLoS pathogens · 2024Article
- Managing sepsis and septic shock in an endothelial glycocalyx-friendly way: from the viewpoint of surviving sepsis campaign guidelines.Annals of intensive care · 2024Review
- The effect of immunosuppressive therapies on the endothelial host response in critically ill COVID-19 patients.Scientific reports · 2024Article
- Changes in plasma endocan level are related to circulatory but not respiratory failure in critically ill patients with COVID-19.Scientific reports · 2023Observational
- Review
- Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies.Acta pharmacologica Sinica · 2023Review
- Article
- Treating COVID-19: Targeting the Host Response, Not the Virus.Life (Basel, Switzerland) · 2023Review
- Immuno-Modulatory Effects of Dexamethasone in Severe COVID-19-A Swedish Cohort Study.Biomedicines · 2023Article
- COVID-19 immunopathology: From acute diseases to chronic sequelae.Journal of medical virology · 2023Review
- Endothelial Damage and the Microcirculation in Critical Illness.Biomedicines · 2022Review
- Immune system-related soluble mediators and COVID-19: basic mechanisms and clinical perspectives.Cell communication and signaling : CCS · 2022Review
- Need for a Standardized Translational Drug Development Platform: Lessons Learned from the Repurposing of Drugs for COVID-19.Microorganisms · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Dexamethasone provides benefits in patients with coronavirus disease 2019 (COVID-19), although data regarding immunological profiles and viral clearance are limited. This study aimed to evaluate for differences in biomarkers among patients with severe COVID-19 who did and did not receive dexamethasone. We measured plasma biomarkers of lung epithelial/endothelial injury and inflammation in 31 patients with severe COVID-19 and in 13 controls. Changes in biomarkers and clinical parameters were compared during the 7-day period among COVID-19 patients, and also according to dexamethasone use. Thirty-two patients with severe COVID-19 who received mechanical ventilation (n = 6), high-flow nasal cannula (n = 11), and supplemental oxygen (n = 15) were analyzed. Relative to controls, patients with severe COVID-19 had significantly higher concentrations of biomarkers related to glycocalyx shedding (endocan and syndecan-1), endothelial injury (von Willebrand factor), and inflammation (soluble receptor for advanced glycation end-products [sRAGE] and interleukin-6). The 7-day decreases in biomarkers of endothelial injury (angiopoietin-2 [Ang-2] and intercellular adhesion molecule-1 [ICAM-1]) and sRAGE, but not in the biomarker of lung epithelial injury (surfactant protein D), were correlated with decreases in C-reactive protein and radiologic score at day 7. Twenty patients (63%) received dexamethasone, and the dexamethasone and non-dexamethasone groups differed in terms of disease severity. However, dexamethasone was associated marginally with increased SpO2/FiO2 and significantly with decreases in C-reactive protein and radiologic score after adjusting for baseline imbalances. Furthermore, the dexamethasone group exhibited a significant decrease in the concentrations of Ang-2, ICAM-1, soluble form of the Tie2 receptor (a biomarker of glycocalyx shedding), and sRAGE. Both groups exhibited a clinically insignificant increase in the cycle threshold value. Severe COVID-19 may be characterized by more severe endothelial injury and inflammation, and less severe lung epithelial injury. There is a possibility that dexamethasone improved severe COVID-19 and related endothelial injury without delaying viral clearance.
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