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Background <p>Heparin-binding protein (HBP) is an inflammatory protein released by activated polymorphonuclear white cells. It has been suggested as a predictor of sepsis progression and organ dysfunction and plays a role in the pathophysiology of endothelial dysfunction. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor with pro-inflammatory effects, and high levels are found in patients with sepsis and acute respiratory distress syndrome. We investigated HBP and ET-1 plasma levels in critical COVID-19 disease with the aim of evaluating whether they were associated with 60-day mortality or the need for invasive mechanical ventilation (IMV). These levels were compared with those of a cohort of post-trauma intensive care unit (ICU) patients.</p> Methods <p>We included 96 patients with critical COVID-19 disease in 2020 and ten post-trauma ICU patients. Blood samples were collected at ICU admission, and plasma levels of HBP and ET-1 were measured. Clinical and laboratory data were collected until ICU discharge or death.</p> Results <p>In COVID-19 patients, plasma levels of HBP were markedly increased, with a median level of 150 ng/ml (IQR 47–299), compared to 13.3 ng/ml (IQR 8.8–62.1), <i>p</i> &lt; 0.0001 in the trauma ICU patients. There was no association between HBP levels and 60-day mortality or need for IMV. The levels of ET-1 were 1.6 pg/ml (IQR 1.2–1.9) in the COVID-19 cohort and 2.0 pg/ml (IQR 1.2–2.8), <i>p</i> = 0.25 in the trauma ICU cohort. COVID-19 patients requiring IMV hade higher ET-1 levels than those who did not require such treatment; however, no association was found in a logistic regression model when adjusted for age, sex and body mass index. There was no correlation between plasma HBP and ET-1 levels. Inflammatory parameters such as C-reactive protein, procalcitonin, ferritin, and interleukin-6, were elevated but did not distinguish survivors from non-survivors.</p> Conclusion <p>While HBP levels are markedly elevated in critical COVID-19, they do not predict outcomes at ICU admission. ET-1 levels were also not linked to mortality or the need for IMV.</p>

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Heparin-binding protein and Endothelin-1 in critical COVID-19

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Halla Halldorsdottir,
  • Jesper Eriksson,
  • Olav Rooyackers,
  • Jonathan Grip,
  • Johan Mårtensson,
  • Eddie Weitzberg,
  • Anders Oldner

摘要

Background

Heparin-binding protein (HBP) is an inflammatory protein released by activated polymorphonuclear white cells. It has been suggested as a predictor of sepsis progression and organ dysfunction and plays a role in the pathophysiology of endothelial dysfunction. Endothelin-1 (ET-1) is a potent endothelium-derived vasoconstrictor with pro-inflammatory effects, and high levels are found in patients with sepsis and acute respiratory distress syndrome. We investigated HBP and ET-1 plasma levels in critical COVID-19 disease with the aim of evaluating whether they were associated with 60-day mortality or the need for invasive mechanical ventilation (IMV). These levels were compared with those of a cohort of post-trauma intensive care unit (ICU) patients.

Methods

We included 96 patients with critical COVID-19 disease in 2020 and ten post-trauma ICU patients. Blood samples were collected at ICU admission, and plasma levels of HBP and ET-1 were measured. Clinical and laboratory data were collected until ICU discharge or death.

Results

In COVID-19 patients, plasma levels of HBP were markedly increased, with a median level of 150 ng/ml (IQR 47–299), compared to 13.3 ng/ml (IQR 8.8–62.1), p < 0.0001 in the trauma ICU patients. There was no association between HBP levels and 60-day mortality or need for IMV. The levels of ET-1 were 1.6 pg/ml (IQR 1.2–1.9) in the COVID-19 cohort and 2.0 pg/ml (IQR 1.2–2.8), p = 0.25 in the trauma ICU cohort. COVID-19 patients requiring IMV hade higher ET-1 levels than those who did not require such treatment; however, no association was found in a logistic regression model when adjusted for age, sex and body mass index. There was no correlation between plasma HBP and ET-1 levels. Inflammatory parameters such as C-reactive protein, procalcitonin, ferritin, and interleukin-6, were elevated but did not distinguish survivors from non-survivors.

Conclusion

While HBP levels are markedly elevated in critical COVID-19, they do not predict outcomes at ICU admission. ET-1 levels were also not linked to mortality or the need for IMV.