Endothelial function provides early prognostic information in patients with COVID-19: A cohort study - 18/08/21
, Guilherme Dionir Back a , Cássia da Luz Goulart a , Bianca Cristina Domingos a , Ross Arena b, c , Audrey Borghi-Silva a, c, ⁎
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Abstract |
Background |
The prothrombotic phenotype and diffuse intravascular coagulation observed in COVID-19 reflect endothelial dysfunction, which is linked to blood flow delivery deficiencies and cardiovascular risk. Assessments of detect vascular deficiencies among newly diagnosed and hospitalized patients due to COVID-19 have yet to be determined.
Objective |
To assess endothelial function characteristics in relation to length of hospitalization and mortality in patients diagnosed with COVID-19 and compare to patients without COVID-19.
Methods |
A prospective observational study involving 180 patients with confirmed COVID-19 (COVID-19 group) or suspected and ruled out COVID-19 (Non-COVID-19 group). Clinical evaluation and flow mediated vasodilation (FMD) were performed between the first 24–48 h of hospitalization. Patients were followed until death or discharge.
Results |
We evaluated 98 patients (COVID-19 group) and 82 (Non-COVID-19 group), COVID-19 group remained hospitalized longer and more deaths occurred compared to the Non-COVID-19 group (p = 0.01; and p < 0.01). Patients in COVID-19 group also had a significantly greater reduction in both FMDmm and FMD% (p < 0.01 in both). We found that absolute FMD≤0.26 mm and relative FMD≤3.43% were the ideal cutoff point to predict mortality and longer hospital stay. In Kaplan Meyer's analysis patients had a high probability of death within a period of up to 10 days of hospitalization.
Conclusion |
Patients hospitalized for COVID-19 present endothelial vascular dysfunction early, remained hospitalized longer and had a higher number of deaths, when compared with patients without COVID-19.
Le texte complet de cet article est disponible en PDF.Highlights |
• | First study that evaluated early FMD in hospitalized patients with suspected and COVID-19. |
• | Patients with COVID-19 had a significantly reduction in FMDmm and FMD%. |
• | This population have early endothelial dysfunction. |
• | Patients with COVID-19 spent more days in hospital and had a higher mortality rate. |
• | FMDmm≤0.26 mm was significant predictor of mortality in patients with COVID-19. |
Keywords : COVID-19, Flow-mediated dilation (FMD), Endothelium, Hospitalization
Abbreviations : SARS, ACE2, ARDS, FMD, FMD (mm), FMD (%), ICU, RT-PCR, PPE
Plan
Vol 185
Article 106469- août 2021 Retour au numéro
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