Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19

Background: Endothelial injury can be induced by coronavirus disease 2019 (COVID-19) and seems to exert a crucial pathogenic role in its most severe clinical manifestations. We aimed to investigate the association between brachial artery flow-mediated dilation (bFMD), a potential clinical and non-in...

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Autores principales:	Vanessa Bianconi, Massimo Raffaele Mannarino, Filippo Figorilli, Elisabetta Schiaroli, Elena Cosentini, Giuseppe Batori, Ettore Marini, Amirhossein Sahebkar, Francesco Grignani, Anna Gidari, Daniela Francisci, Matteo Pirro
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	SARS-CoV-2 COVID-19 pneumonia endothelial dysfunction bFMD Medicine R
Acceso en línea:	https://doaj.org/article/3bb959daea4d460089802d2b85d10a4f
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spelling	oai:doaj.org-article:3bb959daea4d460089802d2b85d10a4f2021-11-25T18:03:00ZLow Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-1910.3390/jcm102254562077-0383https://doaj.org/article/3bb959daea4d460089802d2b85d10a4f2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5456https://doaj.org/toc/2077-0383Background: Endothelial injury can be induced by coronavirus disease 2019 (COVID-19) and seems to exert a crucial pathogenic role in its most severe clinical manifestations. We aimed to investigate the association between brachial artery flow-mediated dilation (bFMD), a potential clinical and non-invasive measure of endothelial function, and in-hospital prognosis of COVID-19 patients. Methods: Brachial artery flow-mediated dilation was assessed in hospitalized COVID-19 patients within 48 h of hospital admission. The association between bFMD and either intensive care unit (ICU) admission or in-hospital death was explored using univariable and multivariable analyses. Results: Four hundred and eight patients were enrolled. Significantly lower bFMD values emerged in COVID-19 patients with either radiographic signs of pneumonia, respiratory distress, or the need for non-invasive ventilation compared with patients without these signs (<i>p</i> < 0.001, <i>p</i> = 0.001, and <i>p</i> < 0.001, respectively). Forty-two (10%) patients were admitted to the ICU, 76 (19%) patients died, and 118 (29%) patients met the composite endpoint of ICU admission/in-hospital death. At unadjusted Cox regression analysis showed that low bFMD (<4.4%, the median value) was associated with a higher risk for the composite endpoint of ICU admission/in-hospital death compared with high bFMD (≥4.4%, the median value) (HR 1.675, 95% CI 1.155–2.428, <i>p</i> = 0.007). Multi-adjusted Cox regression analyses showed that low bFMD was independently associated with a 1.519- to 1.658-fold increased risk for the composite endpoint of ICU admission/in-hospital death. Conclusions: Low bFMD predicts an unfavorable in-hospital prognosis in COVID-19 patients. The measurement of bFMD may be clinically useful in the prognostic stratification of COVID-19 patients upon hospital admission.Vanessa BianconiMassimo Raffaele MannarinoFilippo FigorilliElisabetta SchiaroliElena CosentiniGiuseppe BatoriEttore MariniAmirhossein SahebkarFrancesco GrignaniAnna GidariDaniela FrancisciMatteo PirroMDPI AGarticleSARS-CoV-2COVID-19pneumoniaendothelial dysfunctionbFMDMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5456, p 5456 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SARS-CoV-2 COVID-19 pneumonia endothelial dysfunction bFMD Medicine R
spellingShingle	SARS-CoV-2 COVID-19 pneumonia endothelial dysfunction bFMD Medicine R Vanessa Bianconi Massimo Raffaele Mannarino Filippo Figorilli Elisabetta Schiaroli Elena Cosentini Giuseppe Batori Ettore Marini Amirhossein Sahebkar Francesco Grignani Anna Gidari Daniela Francisci Matteo Pirro Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
description	Background: Endothelial injury can be induced by coronavirus disease 2019 (COVID-19) and seems to exert a crucial pathogenic role in its most severe clinical manifestations. We aimed to investigate the association between brachial artery flow-mediated dilation (bFMD), a potential clinical and non-invasive measure of endothelial function, and in-hospital prognosis of COVID-19 patients. Methods: Brachial artery flow-mediated dilation was assessed in hospitalized COVID-19 patients within 48 h of hospital admission. The association between bFMD and either intensive care unit (ICU) admission or in-hospital death was explored using univariable and multivariable analyses. Results: Four hundred and eight patients were enrolled. Significantly lower bFMD values emerged in COVID-19 patients with either radiographic signs of pneumonia, respiratory distress, or the need for non-invasive ventilation compared with patients without these signs (<i>p</i> < 0.001, <i>p</i> = 0.001, and <i>p</i> < 0.001, respectively). Forty-two (10%) patients were admitted to the ICU, 76 (19%) patients died, and 118 (29%) patients met the composite endpoint of ICU admission/in-hospital death. At unadjusted Cox regression analysis showed that low bFMD (<4.4%, the median value) was associated with a higher risk for the composite endpoint of ICU admission/in-hospital death compared with high bFMD (≥4.4%, the median value) (HR 1.675, 95% CI 1.155–2.428, <i>p</i> = 0.007). Multi-adjusted Cox regression analyses showed that low bFMD was independently associated with a 1.519- to 1.658-fold increased risk for the composite endpoint of ICU admission/in-hospital death. Conclusions: Low bFMD predicts an unfavorable in-hospital prognosis in COVID-19 patients. The measurement of bFMD may be clinically useful in the prognostic stratification of COVID-19 patients upon hospital admission.
format	article
author	Vanessa Bianconi Massimo Raffaele Mannarino Filippo Figorilli Elisabetta Schiaroli Elena Cosentini Giuseppe Batori Ettore Marini Amirhossein Sahebkar Francesco Grignani Anna Gidari Daniela Francisci Matteo Pirro
author_facet	Vanessa Bianconi Massimo Raffaele Mannarino Filippo Figorilli Elisabetta Schiaroli Elena Cosentini Giuseppe Batori Ettore Marini Amirhossein Sahebkar Francesco Grignani Anna Gidari Daniela Francisci Matteo Pirro
author_sort	Vanessa Bianconi
title	Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
title_short	Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
title_full	Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
title_fullStr	Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
title_full_unstemmed	Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19
title_sort	low brachial artery flow-mediated dilation predicts worse prognosis in hospitalized patients with covid-19
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3bb959daea4d460089802d2b85d10a4f
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Low Brachial Artery Flow-Mediated Dilation Predicts Worse Prognosis in Hospitalized Patients with COVID-19

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