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

Abstract 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 s...

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Main Authors: Susumu Fukahori, Yurika Kawazoe, Jung Yeon Han, Narasaiah Kolliputi, Kaitlyn Lezama, Rajesh Kumar, Hiroshi Mukae, Richard F. Lockey, Iset Medina Vera, Kami Kim, Seong H. Cho
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-06517-5
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author Susumu Fukahori
Yurika Kawazoe
Jung Yeon Han
Narasaiah Kolliputi
Kaitlyn Lezama
Rajesh Kumar
Hiroshi Mukae
Richard F. Lockey
Iset Medina Vera
Kami Kim
Seong H. Cho
author_facet Susumu Fukahori
Yurika Kawazoe
Jung Yeon Han
Narasaiah Kolliputi
Kaitlyn Lezama
Rajesh Kumar
Hiroshi Mukae
Richard F. Lockey
Iset Medina Vera
Kami Kim
Seong H. Cho
author_sort Susumu Fukahori
collection DOAJ
description Abstract 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.
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spelling doaj-art-53270e5bfcc94b719d269de464e06d692025-08-20T04:02:51ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-06517-5Elevated plasma level of PAI-1 is associated with severe COVID-19Susumu Fukahori0Yurika Kawazoe1Jung Yeon Han2Narasaiah Kolliputi3Kaitlyn Lezama4Rajesh Kumar5Hiroshi Mukae6Richard F. Lockey7Iset Medina Vera8Kami Kim9Seong H. Cho10Division of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineClinical Research Center, Nagasaki University HospitalDivision of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineDivision of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineDivision of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineDivision of Allergy and Immunology, Department of Pediatrics, Northwestern University and the Ann and Robert H. Lurie Children’s HospitalDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesDivision of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineDivision of Infectious Disease, Department of Internal Medicine, USF Morsani College of MedicineDivision of Infectious Disease, Department of Internal Medicine, USF Morsani College of MedicineDivision of Allergy and Immunology, Department of Internal Medicine, USF Morsani College of MedicineAbstract 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.https://doi.org/10.1038/s41598-025-06517-5COVID-19PAI-1BiomarkerPrognostic factor
spellingShingle Susumu Fukahori
Yurika Kawazoe
Jung Yeon Han
Narasaiah Kolliputi
Kaitlyn Lezama
Rajesh Kumar
Hiroshi Mukae
Richard F. Lockey
Iset Medina Vera
Kami Kim
Seong H. Cho
Elevated plasma level of PAI-1 is associated with severe COVID-19
Scientific Reports
COVID-19
PAI-1
Biomarker
Prognostic factor
title Elevated plasma level of PAI-1 is associated with severe COVID-19
title_full Elevated plasma level of PAI-1 is associated with severe COVID-19
title_fullStr Elevated plasma level of PAI-1 is associated with severe COVID-19
title_full_unstemmed Elevated plasma level of PAI-1 is associated with severe COVID-19
title_short Elevated plasma level of PAI-1 is associated with severe COVID-19
title_sort elevated plasma level of pai 1 is associated with severe covid 19
topic COVID-19
PAI-1
Biomarker
Prognostic factor
url https://doi.org/10.1038/s41598-025-06517-5
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