Angiopoietin-2 levels in COVID-19 patients as a marker of endotheliopathy

Background:COVID-19 is described as endothelial disease, endothelial markers in COVID-19 patients could serve as an early indicator of severity of the disease, Angiopoietin -2 is an angiogenesis regulator it is released upon endothelial activation. This research seeks to assess serum level of angiopoietin-2 among COVID-19 patients requiring ICU admission compared to non-ICU patients with mild symptoms to assess the potential of angiopoietin-2 to predict ICU admission among patients with COVID-19 and investigated for the relation between angiopoietin-2 levels and COVID-19 severity markers.Subjects and Methods:The study included forty consecutive COVID-19 patients admitted through the emergency department who met established criteria for hospitalization.They were divided according to requirement to ICU admission in to two groups Group I included 20patients admitted to chest ICU with severe COVID-19 symptoms and 20 patients that did not require ICU admission with mild to moderate symptoms, All COVID-19-suspected patients undergo Clinical examination,chest computed tomography(CT)scan,and laboratory assessment.Results:There was statistically significant increase in serum angiopoietin-2 of ICU patients when compared to non-ICU patients (P value =0.001*)Angiopoietin-2 showed significant negative correlation with absolute lymphocytes among ICU patients (r = -0.454*,p value =0.015*),ROC curve analysis showed higher sensitivity and specificity of Angiopoietin-2 over D dimer in predicting ICU admission for COVID 19 patients.Conclusions:Estimation of serum level of angiopoietin-2 could act as valuable predictor of the severity of COVID-19 patients,so It is a crucial predictive factor for direct ICU admission in COVID-19 patients and These data may be crucial for initiating treatment in the early stages of the disease.