Carotid intima-media thickness and flow-mediated dilation do not predict acute in-hospital outcomes in patients hospitalized with COVID-19.

Cristina-Oliveira, Michelle; Meireles, Kamila; Gil, Saulo; Cavalcante Assis, F�bio; Geber-J�nior, Jo�o Carlos; Shinjo, Samuel Katsuyuki; Possolo de Souza, Heraldo; Cruz Santana, Alfredo Nicodemos; Swinton, Paul A.; Drager, Luciano F.; Gualano, Bruno; Roschel, Hamilton; Pe�anha, Tiago

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 (cIMTmean and cIMTmax) 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. cIMTmean and cIMTmax were predictors of mortality and thrombotic events in the univariate analysis (cIMTmean and mortality: unadjusted OR 12.71 [95% CI 1.71-94.48]; P = 0.014; cIMTmean and thrombotic events: unadjusted OR 11.94 [95% CI 1.64-86.79]; P = 0.015; cIMTmax and mortality: unadjusted OR 8.47 [95% CI 1.41-51.05]; P = 0.021; cIMTmax 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.

Citation

CRISTINA-OLIVEIRA, M., MEIRELES, K., GIL, S., CAVALCANTE ASSIS, F., GEBER-JÚNIOR, J.C., SHINJO, S.K., POSSOLO DE SOUZA, H., CRUZ SANTANA, A.N., SWINTON, P.A., DRAGER, L.F., GUALANO, B., ROSCHEL, H. and PEÇANHA, T. 2022. Carotid intima-media thickness and flow-mediated dilation do not predict acute in-hospital outcomes in patients hospitalized with COVID-19. American journal of physiology: heart and circulatory physiology [online], 322(6), pages H906-H913. Available from: https://doi.org/10.1152/ajpheart.00026.2022

• Journal Article Type: Article
• Acceptance Date: Mar 18, 2022
• Online Publication Date: Apr 22, 2022
• Publication Date: Jun 30, 2022
• Deposit Date: Mar 31, 2022
• Publicly Available Date: May 19, 2022
• Journal: American journal of physiology: heart and circulatory physiology
• Print ISSN: 0363-6135
• Electronic ISSN: 1522-1539
• Publisher: American Physiological Society
• Peer Reviewed: Peer Reviewed
• Volume: 322
• Issue: 6
• Pages: H906-H913
• DOI: https://doi.org/10.1152/ajpheart.00026.2022
• Keywords: Endothelium; Atherosclerosis; SARS-CoV-2; Mortality; Nitric oxide; Thrombosis; COVID-19
• Public URL: https://rgu-repository.worktribe.com/output/1628181