VEGF and sFlt-1 Levels in the Pathogenesis and Severity of COVID-19 Disease

Study Overview
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Brief Summary
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To assess blood levels of vasoactive mediators that may regulate pulmonary endothelial permeability and contribute to multi-organ injury in patients with COVID-19 disease and to correlate the levels of these mediators with disease outcomes such as ICU admission, length of ventilatory support, respiratory failure, kidney failure, heart failure, and death.

Detailed Description
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When patients are sick with other lung infections (pneumonias) caused by viruses or bacteria there are changes in a pathway that regulates the leakiness the tiny airspaces inside the lungs. Even bigger changes in this pathway are seen when patients develop severe breathing difficulties (acute respiratory distress syndrome) similar to what is seen in patients who get really sick with COVID-19 disease. There are important changes in this pathway that occur in patients who have preexisting cardiovascular (heart) disease who do not have lung infections. The investigator will evaluate these levels in patients with COVID-19 because the investigator believes that this baseline difference in pathway regulation may be one reason patients with heart disease who contract COVID-19 get sicker than patients without heart or vascular disease. The investigator will also assess the levels of components of this pathway in patients who are less sick with those who became sick enough to require a tube to help them breathe because this is important to determine if COVID-19 lung disease has a similar effect on this pathway as other lung infections like flu and bacterial pneumonias.

Official Title
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COVID-19 RELATED SUBMISSION: VEGF and sFlt-1 Levels in the Pathogenesis and Severity of COVID-19 Disease

Conditions
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COVID-19 Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Positive test for COVID-19 (SARS-CoV-2 infection) >=18 years Blood (plasma) specimen(s) available in the CCTS biorepository Exclusion Criteria: <18 years Lack of blood specimen

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1:<br>Group 1: COVID-19 + inpatients who did not require mechanical ventilation (25 patients); | |
| Group 2:<br>Group 2: COVID-19 + inpatients who required mechanical ventilation (25 patients). | |
| Group 3:<br>Group 3: COVID-19 + inpatients with no preexisting cardiovascular disease (25 patients) | |
| Group 4:<br>Group 4: COVID-19 + inpatients with preexisting cardiovascular disease (25 patients). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Laboratory Assays | The primary outcome measure is the ratio of soluble fms-like tyrosine kinase receptor-1 (sFlt-1) to vascular endothelial growth factor (VEGF) which will be obtained using an immunoassay on blood samples. The specimens will be analyzed using enzyme-linked immunosorbent assay and reported as a ratio | 7-14 days after symptom onset | 
| VEGF-A | Plasma samples will be analyzed to measure VEGF-A | 7-14 days after symptom onset | 
| VEGF-C | Plasma samples will be analyzed to measure VEGF-C | 7-14 days after symptom onset | 
| VEGF-D | Plasma samples will be analyzed to measure VEGF-D | 7-14 days after symptom onset | 
| Tie-2 | Plasma samples will be analyzed to measure Tie-2 | 7-14 days after symptom onset | 
| Flt-1 | Plasma samples will be analyzed to measure Flt-1 | 7-14 days after symptom onset | 
| PlGF | Plasma samples will be analyzed to measure PlGF | 7-14 days after symptom onset | 
| FGF | Plasma samples will be analyzed to measure FGF | 7-14 days after symptom onset | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19, SARS-CoV-2 viral infection, VEGF and sFlt-1 levels