What is the value of understanding the properties of the endothelial glycocalyx in the management of COVID-19-affected patients?

Alexandre Boulanger1, Anne-Sophie Dincq1, Benoit Rondelet2, Maximilien Gourdin1 Published in the journal : March 2022 Category : Anesthesiology

Summary :

COVID-19 is an emerging viral infection caused by SARS-CoV-2 coronavirus strain. Following the two-year pandemic, clinicians have made significant progress in their understanding of the clinical disease manifestations, particularly by highlighting the primary role of the endothelial glycocalyx. This micro-fibrillar complex structure is located at the apical pole of the endothelial cell. It constitutes the histological barrier between cell and vascular lumen; in many ways, this structure behaves as an organ in its own way. The pathophysiological study of the endothelial glycocalyx has highlighted its usefulness in understanding both the COVID-19 and its complications. This article thus sought to look at the disease from a different angle, while summarizing the relevant data we have learned over the past two years for the clinicians.

What is already known about the topic?

The endothelial glycocalyx is a protein-carbohydrate membrane structure at the interface between the vascular lumen and endothelial cell. Its role is essential in the interactions between the figurative blood elements and the endothelial cells. Its multiple properties render it an organ in its own right. Major inflammatory syndromes, such as those occurring in the polytraumatized patients or those suffering from sepsis, exert a major impact on vascular homeostasis.

What does this article bring up for us?

This article discusses the relevance of the endothelial glycocalyx in understanding COVID-19. The inflammatory storm that characterizes COVID-19 at a certain disease stage likely exerts a major impact on vascular homeostasis. Understanding the properties and role of endothelial glycocalyx allows us to better understand the disease, its complications, and treatment options.

Key Words

Endothelial glycocalyx, destruction, treatment, hypertension, diabetes, COVID-19