ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

Abstract

Background: Viral infection can compound the severity of pre-existing inflammation caused by underlying diseases. For those with a chronic, immune-related condition such as diabetic foot ulcers (DFUs), the coronavirus disease (COVID-19) serves to exacerbate the inflammatory burden. Serum levels of intracellular adhesion molecule-1 (ICAM-1), a primary mediator of cell adhesion express in the inflammatory process, are often used to indicate the gravity of all inflammatory conditions. Therefore, the purpose of this study was to investigate serum ICAM-1 levels before and after debridement in patients with DFUs who were also diagnosed as COVID-19 positive compared with those who were COVID-19 negative. Methods: 20 patients with DFUs were screened for COVID-19 and then divided into COVID-19 positive and negative groups according to the results. Before debridement, chest x-rays and blood analysis, including ICAM-1 serum levels, were performed in both groups. Only ICAM-1 serum levels were measured after debridement. Results: Of the 20 patients included in this study, 55% were male (n = 11) and 45% were female (n = 9). The mean age was 52.9 ± 1.9 years. ICAM-1 levels in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group (median 317.2 vs 149.2, respectively; p < 0.001). Serum levels of ICAM-1 reduced significantly in patients with DFU in the COVID-19-positive group were significantly higher than those in the COVID-19-negative group after debridement (median 312.5 vs 130.3; p < 0.001). Conclusion: ICAM-1 serum levels represent an additional, initial screening marker for COVID-19. HIGHLIGHTS Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2. In patients with diabetes, hyperglycemia causes both the innate and adaptive immune responses. ICAM-1 facilitates leukocyte-endothelial binding and the migration of leukocytes across the endothelial barrier. ICAM-1 levels in patients with DFU in the COVID-19-positive group were significantly higher than the COVID-19-negative group. ICAM-1 serum levels represent an additional, initial screening marker for COVID-19.

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