Determinants of endothelial dysfunction in noncritically ill hospitalized COVID-19 patients: A cross-sectional study

Author(s):Show less -

Heubel, Alessandro Domingues ^[1] ; Viana, Ariane Aparecida ^[2] ; Linares, Stephanie Nogueira ^[1] ; do Amaral, Vanessa Teixeira ^[2] ; Schafauser, Nathany Souza ^[1] ; Orikassa de Oliveira, Gustavo Yudi ^[2] ; Ramirez, Paula Camila ^{[3, 4]} ; Martinelli, Bruno ^[5] ; Alexandre, Tiago da Silva ^[3] ; Borghi-Silva, Audrey ^[1] ; Ciolac, Emmanuel Gomes ^[2] ; Mendes, Renata Goncalves ^[1]

Affiliation

^[1] Univ Fed Sao Carlos, Dept Phys Therapy, Cardiopulm Physiotherapy Lab, Sao Carlos, SP - Brazil

^[2] Sao Paulo State Univ, Sch Sci, Dept Phys Educ, Exercise & Chron Dis Res Lab, Bauru, SP - Brazil

^[3] Univ Fed Sao Carlos, Dept Gerontol, Sao Carlos, SP - Brazil

^[4] Univ Ind Santander, Dept Phys Therapy, Santander - Colombia

^[5] Sacred Heart Univ Ctr, Dept Phys Therapy, Bauru, SP - Brazil

• Document type: Journal article
• Source: OBESITY; v. 30, n. 1 NOV 2021.
• Web of Science Citations: 1

Abstract

Objective The aim of this study was to identify determinants of endothelial dysfunction in patients hospitalized with acute COVID-19. Methods A total of 109 hospitalized COVID-19 patients in noncritical status were cross-sectionally studied. Clinical data (age, sex, comorbidities, and medications) and BMI were assessed. Laboratory tests included serum hemoglobin, leukocytes, lymphocytes, platelets, C-reactive protein, ferritin, D-dimer, and creatinine. Physical status was evaluated using a handgrip dynamometer. Endothelial function was assessed noninvasively using the flow-mediated dilation (FMD) method. Results The sample average age was 51 years, 51% of patients were male, and the most frequent comorbidity was obesity (62%). Univariate analysis showed association of lower FMD with higher BMI, hypertension, use of oral antihypertensive, higher blood levels of creatinine, and larger baseline artery diameter. After adjusting for confounders, the multivariate analysis showed BMI (95% CI: -0.26 to -0.11; p < 0.001) as the major factor associated with FMD. Other factors associated with FMD were baseline artery diameter (95% CI: -1.77 to -0.29; p = 0.007) and blood levels of creatinine (95% CI: -1.99 to -0.16; p = 0.022). Conclusions Increased BMI was the major factor associated with endothelial dysfunction in noncritically hospitalized COVID-19 patients. This may explain one of the pathways in which obesity may increase the risk for severe COVID-19. (AU)

• FAPESP's process: 15/09259-2 - Acute hemodynamic responses to heated water-based exercise in older hypertensive patients
• Grantee: Awassi Yophiwa Ngomane
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 15/26501-1 - Study of limiting factors to physical exercise and adjunct effects to rehabilitation on cardiorespiratory disease: a multicentre approach
• Grantee: Audrey Borghi Silva
• Support Opportunities: Research Projects - Thematic Grants