Publication date: Jul 14, 2025

The pathogenesis of COVID-19 highlights the pivotal role of endothelial dysfunction and dysregulated angiogenic signaling. Vascular endothelial growth factor A (VEGF-A) and its soluble receptor (sVEGFR-1) are critical regulators of vascular integrity. This study aimed to investigate the association between serum VEGF-A and sVEGFR-1 levels and disease severity in patients diagnosed with COVID-19. In this single-center observational study, 92 COVID-19 patients, classified into mild, moderate, and severe categories, and 29 healthy controls were enrolled. Serum VEGF-A and sVEGFR-1 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Clinical, demographic, and laboratory data were collected. Statistical analyses included ANOVA, Kruskal-Wallis, Spearman correlation, logistic regression, and ROC curve analysis. Both VEGF-A and sVEGFR-1 levels were significantly lower in severe COVID-19 patients compared to controls (p < 0. 001). Negative correlations were observed between VEGF-A levels and disease severity (r = -0. 55, p < 0. 001), and between sVEGFR-1 levels and severity (r = -0. 48, p < 0. 001). Logistic regression analysis identified VEGF-A as an independent predictor of severe COVID-19 (OR = 0. 964, p = 0. 021). No significant differences in VEGF-A or sVEGFR-1 levels were found between survivors and non-survivors among the severe group. Serum VEGF-A and sVEGFR-1 levels are inversely associated with COVID-19 disease severity, suggesting their potential role as early prognostic biomarkers. These findings underscore the importance of endothelial dysfunction in COVID-19 progression and encourage further research on angiogenic markers in viral infections.

Original Article