Plasma endocan was recognized as the independent risk factor for developing ARDS in patients (OR: 1.57, 95% CI: 1.14–2.25, p = 0.021). Plasma endocan resulted in an AUC of 0.754, 95% CI of 0.642–0.866, a cutoff value of 11.6 ng/mL, a sensitivity of 78.7%, and a specificity of 70.3%, respectively (p < 0.01). Here, ESM1 is linked to acute respiratory distress syndrome.