Observational studySignal transduction and targeted therapy2021
Endothelial dysfunction contributes to severe COVID-19 in combination with dysregulated lymphocyte responses and cytokine networks.
Observational study in Signal transduction and targeted therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Mucorales: A systematic review to inform the World Health Organization priority list of fungal pathogens.Medical mycology · 2024Pooled it
- Cerebral small vessel disease pathology in COVID-19 patients: A systematic review.Ageing research reviews · 2023Pooled it
- Mechanisms of pediatric ischemic strokes in COVID-19: a systematic review.Frontiers in stroke · 2023Pooled it
- Allogenic mesenchymal stromal cells and their extracellular vesicles in COVID-19 induced ARDS: a randomized controlled trial.Stem cell research & therapy · 2023Trial
- Autoimmune diseases in the era of COVID-19: emerging mechanisms, clinical implications, vaccine considerations, and future directions.The Korean journal of internal medicine · 2026Review
- Association between the endothelial activation and stress index and 30-day in-hospital mortality rate in patients with traumatic lung injury: a retrospective analysis based on the MIMIC-IV database.Journal of thoracic disease · 2026Article
- Post-Acute Sequelae Patients with Severe COVID-19 History Show a Prolonged Inflammatory, Vascular Injury Pattern.European journal of immunology · 2026Article
- Diagnostic performance of vascular endothelial growth factor D in severity stratification of pediatric COVID-19 and multisystem inflammatory syndrome in children.Frontiers in immunology · 2026Article
- Novel small molecule inhibitor of GPR68 attenuates endothelial dysfunction and lung injury caused by bacterial lipopolysaccharide.Scientific reports · 2025Article
- Cord blood cytokines/chemokines linked to delays in toddlers exposed to SARS-CoV-2 prenatally.Pediatric research · 2025Article
- Inflammatory Milieu and Specific T-Cell Response Observed Three Months and One Year After SARS-CoV-2 Infection in Long COVID Subjects.International journal of molecular sciences · 2025Article
- Single-Cell Transcriptomic Analysis of the Immune Response to COVID-19 and Tuberculosis Coinfection.Exploration (Beijing, China) · 2025Article
- Exploratory analyses of leukocyte responses in hospitalized patients treated with ozanimod following a severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection.Immunology and cell biology · 2025Article
- Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies.Signal transduction and targeted therapy · 2025Review
- Human herpesvirus reactivation and its potential role in the pathogenesis of post-acute sequelae of SARS-CoV-2 infection.GeroScience · 2025Review
- Unveiling the immunomodulatory dance: endothelial cells' function and their role in non-small cell lung cancer.Molecular cancer · 2025Review
- Dysregulated autoantibodies targeting AGTR1 are associated with the accumulation of COVID-19 symptoms.NPJ systems biology and applications · 2025Article
- Endothelial activation and stress index for prediction of mortality in asthma.Frontiers in medicine · 2025Article
- Targeting CD73 and correcting adenosinergic signaling in critically ill patients.Frontiers in pharmacology · 2025Review
- GPR68 Mediates Lung Endothelial Dysfunction Caused by Bacterial Inflammation and Tissue Acidification.Cells · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 5 institutions in 2 countries.
Funding
Abstract
The systemic processes involved in the manifestation of life-threatening COVID-19 and in disease recovery are still incompletely understood, despite investigations focusing on the dysregulation of immune responses after SARS-CoV-2 infection. To define hallmarks of severe COVID-19 in acute disease (n = 58) and in disease recovery in convalescent patients (n = 28) from Hannover Medical School, we used flow cytometry and proteomics data with unsupervised clustering analyses. In our observational study, we combined analyses of immune cells and cytokine/chemokine networks with endothelial activation and injury. ICU patients displayed an altered immune signature with prolonged lymphopenia but the expansion of granulocytes and plasmablasts along with activated and terminally differentiated T and NK cells and high levels of SARS-CoV-2-specific antibodies. The core signature of seven plasma proteins revealed a highly inflammatory microenvironment in addition to endothelial injury in severe COVID-19. Changes within this signature were associated with either disease progression or recovery. In summary, our data suggest that besides a strong inflammatory response, severe COVID-19 is driven by endothelial activation and barrier disruption, whereby recovery depends on the regeneration of the endothelial integrity.
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Registered trials
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