Elevated plasma level of PAI-1 is associated with severe COVID-19

Evidence indicates endothelial dysfunction in severe coronavirus disease (COVID-19). Plasminogen activator inhibitor-1 (PAI-1) is a marker of endothelial injury and could be a prognostic marker for COVID-19-related hospitalization and outcomes. The association between PAI-1 levels and the severity of COVID-19-related outcomes was investigated in this study. This single-center retrospective chart review included 113 hospitalized adults from 6.29.2020 to 8.1.2021 with confirmed COVID-19. Plasma PAI-1 levels were measured by ELISA. The primary endpoint was the difference in PAI-1 levels between severe and non-severe COVID-19 groups. Severe COVID-19 was defined as the need for ventilator assistance and/or death. The mean age was 60.78 (22 to 103, SD ± 16.93), and 52 were female and 63 male. There was a significant positive correlation between age and PAI-1 levels. PAI-1 levels were significantly higher in patients with hyperlipidemia. PAI-1 levels in patients requiring ventilator assistance and who died versus those who did not are significantly higher. High plasma PAI-1 levels are associated with severe COVID-19, defined as requiring ventilator use and/or death. Thus, PAI-1 may be a biological marker for severe COVID-19.