Murilo Rezende Oliveira1, Guilherme Dionir Back2, Cássia da Luz Goulart3, Bianca Cristina Domingos4, Ross Arena5, Audrey Borghi-Silva6. 1. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, Sao Carlos, CEP: 13565-905, SP, Brazil. Electronic address: murilorezendeoliveira@hotmail.com. 2. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, Sao Carlos, CEP: 13565-905, SP, Brazil. Electronic address: guilhermeback4@gmail.com. 3. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, Sao Carlos, CEP: 13565-905, SP, Brazil. Electronic address: luz.cassia@hotmail.com. 4. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, Sao Carlos, CEP: 13565-905, SP, Brazil. Electronic address: bibi.domingos87@gmail.com. 5. Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: rarena70@gmail.com. 6. Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of Sao Carlos, UFSCar, Rodovia Washington Luis, KM 235, Monjolinho, Sao Carlos, CEP: 13565-905, SP, Brazil; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: audrey@ufscar.br.
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.
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.
Authors: Thomas Gille; Pradeesh Sivapalan; Georgios Kaltsakas; Shailesh B Kolekar; Matthew Armstrong; Rachel Tuffnell; Rachael A Evans; Guido Vagheggini; Luiza Helena Degani-Costa; Cláudia Vicente; Nilakash Das; Vitalii Poberezhets; Camille Rolland-Debord; Sam Bayat; Ioannis Vogiatzis; Frits M E Franssen; Hilary Pinnock; Lowie E G W Vanfleteren Journal: ERJ Open Res Date: 2022-05-23
Authors: Michelle Cristina-Oliveira; Kamila Meireles; Saulo Gil; Fábio Cavalcante Assis; João Carlos Geber-Júnior; Samuel Katsuyuki Shinjo; Heraldo Possolo de Souza; Alfredo Nicodemos Cruz Santana; Paul A Swinton; Luciano F Drager; Bruno Gualano; Hamilton Roschel; Tiago Peçanha Journal: Am J Physiol Heart Circ Physiol Date: 2022-03-25 Impact factor: 4.733