Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/47018
Title: Carotid intima-media thickness and flow-mediated dilation do not predict acute in-hospital outcomes in patients hospitalized with COVID-19
Authors: CRISTINA-OLIVEIRA, MichelleMEIRELES, KamilaGIL, SauloASSIS, Fabio CavalcanteGEBER-JUNIOR, Joao CarlosSHINJO, Samuel KatsuyukiSOUZA, Heraldo Possolo deSANTANA, Alfredo Nicodemos CruzSWINTON, Paul A.DRAGER, Luciano F.GUALANO, BrunoROSCHEL, HamiltonPECANHA, Tiago
Citation: AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, v.322, n.6, p.H906-H913, 2022
Abstract: Studies have suggested a potential role of endothelial dysfunction and atherosclerosis in the pathophysiology of COVID-19. Herein, we tested whether brachial flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT) measured upon hospital admission are associated with acute in-hospital outcomes in patients hospitalized with COVID-19. A total of 211 patients hospitalized with COVID-19 were submitted to assessments of FMD and mean and maximum cIMT (cIMT(mean) and cIMT(max)) within the first 72 h of hospital admission. Study primary outcome was a composite of intensive care unit admission, mechanical ventilation, or death during the hospitalization. These outcomes were also considered independently. Thrombotic events were included as a secondary outcome. Odds ratios (ORs) and confidence intervals (CIs) were calculated using unadjusted and adjusted multivariable logistic regression models. Eighty-eight (42%) participants demonstrated at least one of the composite outcomes. cIMT(mean) and cIMT(max) were predictors of mortality and thrombotic events in the univariate analysis (cIMT(mean) and mortality: unadjusted OR 12.71 [95% CI 1.71-94.48]; P = 0.014; cIMT(mean) and thrombotic events: unadjusted OR 11.94 [95% CI 1.64-86.79]; P = 0.015; cIMT(max) and mortality: unadjusted OR 8.47 [95% CI 1.41-51.05]; P = 0.021; cIMT(max) and thrombotic events: unadjusted OR 12.19 [95% CI 2.03-73.09]; P = 0.007). However, these associations were no longer present after adjustment for potential confounders (P > 0.05). In addition, FMD% was not associated with any outcome. In conclusion, cIMT and FMD are not independent predictors of clinical outcomes in patients hospitalized with COVID-19. These results suggest that subclinical atherosclerosis and endothelial dysfunction may not be the main drivers of COVID-19 complications in patients hospitalized with COVID-19. NEW & NOTEWORTHY Studies have suggested a role of endothelial dysfunction and atherosclerosis in COVID-19 pathophysiology. In this prospective cohort study, we assessed the prognostic value of carotid intima-media thickness (IMT) and flow-mediated dilation (FMD) in patients with COVID-19. Carotid IMT and FMD were not independent predictors of major outcomes. These results suggest that other risk factors may be the main drivers of clinical outcomes in patients with COVID-19.
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Artigos e Materiais de Revistas Científicas - COVID-19
COVID-19

Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/17
LIM/17 - Laboratório de Investigação em Reumatologia

Artigos e Materiais de Revistas Científicas - LIM/51
LIM/51 - Laboratório de Emergências Clínicas

Artigos e Materiais de Revistas Científicas - LIM/63
LIM/63 - Laboratório de Investigação Médica em Sono

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


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