Cargando…
Endothelial function provides early prognostic information in patients with COVID-19: A cohort study
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...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141349/ https://www.ncbi.nlm.nih.gov/pubmed/34175806 http://dx.doi.org/10.1016/j.rmed.2021.106469 |
_version_ | 1783696347374813184 |
---|---|
author | Oliveira, Murilo Rezende Back, Guilherme Dionir da Luz Goulart, Cássia Domingos, Bianca Cristina Arena, Ross Borghi-Silva, Audrey |
author_facet | Oliveira, Murilo Rezende Back, Guilherme Dionir da Luz Goulart, Cássia Domingos, Bianca Cristina Arena, Ross Borghi-Silva, Audrey |
author_sort | Oliveira, Murilo Rezende |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8141349 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81413492021-05-24 Endothelial function provides early prognostic information in patients with COVID-19: A cohort study Oliveira, Murilo Rezende Back, Guilherme Dionir da Luz Goulart, Cássia Domingos, Bianca Cristina Arena, Ross Borghi-Silva, Audrey Respir Med Original Research 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. Elsevier Ltd. 2021 2021-05-23 /pmc/articles/PMC8141349/ /pubmed/34175806 http://dx.doi.org/10.1016/j.rmed.2021.106469 Text en © 2021 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Research Oliveira, Murilo Rezende Back, Guilherme Dionir da Luz Goulart, Cássia Domingos, Bianca Cristina Arena, Ross Borghi-Silva, Audrey Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title | Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title_full | Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title_fullStr | Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title_full_unstemmed | Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title_short | Endothelial function provides early prognostic information in patients with COVID-19: A cohort study |
title_sort | endothelial function provides early prognostic information in patients with covid-19: a cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141349/ https://www.ncbi.nlm.nih.gov/pubmed/34175806 http://dx.doi.org/10.1016/j.rmed.2021.106469 |
work_keys_str_mv | AT oliveiramurilorezende endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy AT backguilhermedionir endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy AT daluzgoulartcassia endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy AT domingosbiancacristina endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy AT arenaross endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy AT borghisilvaaudrey endothelialfunctionprovidesearlyprognosticinformationinpatientswithcovid19acohortstudy |