Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19

Endotheliopathy plays an essential role in the pathophysiology of COVID-19. The endothelial activation and stress index (EASIX) indicates endothelial dysfunction. We aimed to investigate the relationship between a high EASIX score and mortality in patients with COVID-19. We retrospectively reviewed...

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Main Authors: Derya Gokcinar, Ayse Lafci, Seval Izdes
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:COVID
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Online Access:https://www.mdpi.com/2673-8112/5/6/89
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author Derya Gokcinar
Ayse Lafci
Seval Izdes
author_facet Derya Gokcinar
Ayse Lafci
Seval Izdes
author_sort Derya Gokcinar
collection DOAJ
description Endotheliopathy plays an essential role in the pathophysiology of COVID-19. The endothelial activation and stress index (EASIX) indicates endothelial dysfunction. We aimed to investigate the relationship between a high EASIX score and mortality in patients with COVID-19. We retrospectively reviewed COVID-19 patients admitted to the ICU (intensive care unit) of the Ankara Bilkent City Hospital. We recorded hematological and biochemical parameters at the ICU admission and further calculated EASIX with the following equation: EASIX = Lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10<sup>9</sup>/L). Statistical comparisons were made between the surviving and non-surviving groups in terms of EASIX. The median EASIX score was 1.2 (0.7–2.0) in the survivor group and a median of 2.5 (1.6–4.2) in the non-survivor group (<i>p</i> < 0.001). The mean log2-EASIX was 0.2 ± 0.9 in the survivor group and 1.3 ± 1.2 in the non-survivor group (<i>p</i> < 0.001). Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, and IL-6 were statistically significantly higher in the non-survivor group compared to the survivor group. The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of the EASIX score was 2.05 (The area under the curve [AUC] = 0.764, <i>p</i> = 0.001, 95% CI: 0.662–0.847). Our study showed an association between high EASIX scores and poor prognosis in COVID-19 patients. Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, IL-6, EASIX, and log2-EASIX were statistically significantly higher in the non-survivor group compared to the survivor group. Being old and having chronic kidney disease increases the risk of death. Eventually, EASIX can be used to predict mortality in COVID-19 patients.
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spelling doaj-art-52ca977b2e334f9f8cfc286e064c83952025-08-20T03:24:32ZengMDPI AGCOVID2673-81122025-06-01568910.3390/covid5060089Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19Derya Gokcinar0Ayse Lafci1Seval Izdes2Department of Anesthesiology, University of Health Science, Ankara Bilkent City Hospital, Ankara 06800, TurkeyDepartment of Anesthesiology, Ankara Bilkent City Hospital, Ankara 06800, TurkeyDepartment of Anesthesiology, Ankara Yildirim Beyazit University, Ankara Bilkent City Hospital, Ankara 06800, TurkeyEndotheliopathy plays an essential role in the pathophysiology of COVID-19. The endothelial activation and stress index (EASIX) indicates endothelial dysfunction. We aimed to investigate the relationship between a high EASIX score and mortality in patients with COVID-19. We retrospectively reviewed COVID-19 patients admitted to the ICU (intensive care unit) of the Ankara Bilkent City Hospital. We recorded hematological and biochemical parameters at the ICU admission and further calculated EASIX with the following equation: EASIX = Lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10<sup>9</sup>/L). Statistical comparisons were made between the surviving and non-surviving groups in terms of EASIX. The median EASIX score was 1.2 (0.7–2.0) in the survivor group and a median of 2.5 (1.6–4.2) in the non-survivor group (<i>p</i> < 0.001). The mean log2-EASIX was 0.2 ± 0.9 in the survivor group and 1.3 ± 1.2 in the non-survivor group (<i>p</i> < 0.001). Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, and IL-6 were statistically significantly higher in the non-survivor group compared to the survivor group. The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of the EASIX score was 2.05 (The area under the curve [AUC] = 0.764, <i>p</i> = 0.001, 95% CI: 0.662–0.847). Our study showed an association between high EASIX scores and poor prognosis in COVID-19 patients. Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, IL-6, EASIX, and log2-EASIX were statistically significantly higher in the non-survivor group compared to the survivor group. Being old and having chronic kidney disease increases the risk of death. Eventually, EASIX can be used to predict mortality in COVID-19 patients.https://www.mdpi.com/2673-8112/5/6/89COVID-19endothelial activation and stress indexEASIXintensive care unitsprognosismortality
spellingShingle Derya Gokcinar
Ayse Lafci
Seval Izdes
Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
COVID
COVID-19
endothelial activation and stress index
EASIX
intensive care units
prognosis
mortality
title Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
title_full Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
title_fullStr Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
title_full_unstemmed Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
title_short Endothelial Activation and Stress Index (EASIX) to Predict the Outcome of Patients with COVID-19
title_sort endothelial activation and stress index easix to predict the outcome of patients with covid 19
topic COVID-19
endothelial activation and stress index
EASIX
intensive care units
prognosis
mortality
url https://www.mdpi.com/2673-8112/5/6/89
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AT ayselafci endothelialactivationandstressindexeasixtopredicttheoutcomeofpatientswithcovid19
AT sevalizdes endothelialactivationandstressindexeasixtopredicttheoutcomeofpatientswithcovid19