Vascular complications in 305 severely ill patients with COVID-19: a cohort study
ABSTRACT BACKGROUND: Although an association has been made between coronavirus disease 2019 (COVID-19) and microvascular disease, data on vascular complications (other than venous thromboembolism) are sparse. OBJECTIVE: To investigate the vascular complications in severely ill patients hospitalize...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
2022-12-01
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| Series: | São Paulo Medical Journal |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005031296&tlng=en |
| _version_ | 1828089732808048640 |
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| author | Rebeca Mangabeira Correia Brena Costa Santos Ana Alyra Garcia Carvalho Libnah Leal Areias Danielle Akemi Bergara Kuramoto Mariana Raffo Pereda Ana Laura e Silva Aidar Caroline Nicacio Bessa Clezar Marcello Erich Reicher Jorge Eduardo de Amorim Ronald Luiz Gomes Flumignan Luis Carlos Uta Nakano |
| author_facet | Rebeca Mangabeira Correia Brena Costa Santos Ana Alyra Garcia Carvalho Libnah Leal Areias Danielle Akemi Bergara Kuramoto Mariana Raffo Pereda Ana Laura e Silva Aidar Caroline Nicacio Bessa Clezar Marcello Erich Reicher Jorge Eduardo de Amorim Ronald Luiz Gomes Flumignan Luis Carlos Uta Nakano |
| author_sort | Rebeca Mangabeira Correia |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Although an association has been made between coronavirus disease 2019 (COVID-19) and microvascular disease, data on vascular complications (other than venous thromboembolism) are sparse. OBJECTIVE: To investigate the vascular complications in severely ill patients hospitalized with COVID-19 and their association with all-cause mortality. DESIGN AND SETTING: This cohort study was conducted at the Universidade Federal de São Paulo, Brazil. METHODS: All 305 consecutive patients diagnosed with COVID-19 and hospitalized in the intensive care unit (ICU) of a tertiary university hospital from April 2 to July 17, 2021, were included and followed up for 30 days. RESULTS: Of these, 193 (63.3%) were male, and the mean age was 59.9 years (standard deviation = 14.34). The mortality rate was 56.3% (172 patients), and 72 (23.6%) patients developed at least one vascular complication during the follow-up period. Vascular complications were more prevalent in the non-survivors (28.5%) than in the survivors (17.3%) group and included disseminated intravascular coagulation (DIC, 10.8%), deep vein thrombosis (8.2%), acrocyanosis (7.5%), and necrosis of the extremities (2%). DIC (adjusted odds ratio (aOR) 2.30, 95% confidence interval (CI) 1.01–5.24, P = 0.046) and acrocyanosis (aOR 5.21, 95% CI 1.48–18.27, P = 0.009) were significantly more prevalent in the non-survivors than in the survivors group. CONCLUSION: Vascular complications in critically ill COVID-19 patients are common (23.6%) and can be closely related to the mortality rate (56.3%) until 30 days after ICU admission. Macrovascular complications have direct implications for mortality, which is the main outcome of the management of COVID-19. REGISTRATION: RBR-4qjzh7 (https://ensaiosclinicos.gov.br/rg/RBR-4qjzh7). |
| first_indexed | 2024-04-11T05:46:26Z |
| format | Article |
| id | doaj.art-25d8836b36ba4e04b07ecdcdcc2e67fc |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-04-11T05:46:26Z |
| publishDate | 2022-12-01 |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-25d8836b36ba4e04b07ecdcdcc2e67fc2022-12-22T04:42:13ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602022-12-0110.1590/1516-3180.2022.0171.r2.17102022Vascular complications in 305 severely ill patients with COVID-19: a cohort studyRebeca Mangabeira Correiahttps://orcid.org/0000-0002-5107-4216Brena Costa Santoshttps://orcid.org/0000-0002-3422-8324Ana Alyra Garcia Carvalhohttps://orcid.org/0000-0001-5247-2112Libnah Leal Areiashttps://orcid.org/0000-0001-9563-8047Danielle Akemi Bergara Kuramotohttps://orcid.org/0000-0003-1392-6470Mariana Raffo Peredahttps://orcid.org/0000-0001-9475-2550Ana Laura e Silva Aidarhttps://orcid.org/0000-0001-6784-9883Caroline Nicacio Bessa Clezarhttps://orcid.org/0000-0002-0037-0939Marcello Erich Reicherhttps://orcid.org/0000-0003-3237-5280Jorge Eduardo de Amorimhttps://orcid.org/0000-0001-7149-1597Ronald Luiz Gomes Flumignanhttps://orcid.org/0000-0001-6440-8011Luis Carlos Uta Nakanohttps://orcid.org/0000-0002-7996-3269ABSTRACT BACKGROUND: Although an association has been made between coronavirus disease 2019 (COVID-19) and microvascular disease, data on vascular complications (other than venous thromboembolism) are sparse. OBJECTIVE: To investigate the vascular complications in severely ill patients hospitalized with COVID-19 and their association with all-cause mortality. DESIGN AND SETTING: This cohort study was conducted at the Universidade Federal de São Paulo, Brazil. METHODS: All 305 consecutive patients diagnosed with COVID-19 and hospitalized in the intensive care unit (ICU) of a tertiary university hospital from April 2 to July 17, 2021, were included and followed up for 30 days. RESULTS: Of these, 193 (63.3%) were male, and the mean age was 59.9 years (standard deviation = 14.34). The mortality rate was 56.3% (172 patients), and 72 (23.6%) patients developed at least one vascular complication during the follow-up period. Vascular complications were more prevalent in the non-survivors (28.5%) than in the survivors (17.3%) group and included disseminated intravascular coagulation (DIC, 10.8%), deep vein thrombosis (8.2%), acrocyanosis (7.5%), and necrosis of the extremities (2%). DIC (adjusted odds ratio (aOR) 2.30, 95% confidence interval (CI) 1.01–5.24, P = 0.046) and acrocyanosis (aOR 5.21, 95% CI 1.48–18.27, P = 0.009) were significantly more prevalent in the non-survivors than in the survivors group. CONCLUSION: Vascular complications in critically ill COVID-19 patients are common (23.6%) and can be closely related to the mortality rate (56.3%) until 30 days after ICU admission. Macrovascular complications have direct implications for mortality, which is the main outcome of the management of COVID-19. REGISTRATION: RBR-4qjzh7 (https://ensaiosclinicos.gov.br/rg/RBR-4qjzh7).http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005031296&tlng=enMortalityCOVID-19Cohort studiesPeripheral vascular diseasesCritical careVascular complicationsSARS-CoV-2 infectionRetrospective analysis30-days follow-up |
| spellingShingle | Rebeca Mangabeira Correia Brena Costa Santos Ana Alyra Garcia Carvalho Libnah Leal Areias Danielle Akemi Bergara Kuramoto Mariana Raffo Pereda Ana Laura e Silva Aidar Caroline Nicacio Bessa Clezar Marcello Erich Reicher Jorge Eduardo de Amorim Ronald Luiz Gomes Flumignan Luis Carlos Uta Nakano Vascular complications in 305 severely ill patients with COVID-19: a cohort study São Paulo Medical Journal Mortality COVID-19 Cohort studies Peripheral vascular diseases Critical care Vascular complications SARS-CoV-2 infection Retrospective analysis 30-days follow-up |
| title | Vascular complications in 305 severely ill patients with COVID-19: a cohort study |
| title_full | Vascular complications in 305 severely ill patients with COVID-19: a cohort study |
| title_fullStr | Vascular complications in 305 severely ill patients with COVID-19: a cohort study |
| title_full_unstemmed | Vascular complications in 305 severely ill patients with COVID-19: a cohort study |
| title_short | Vascular complications in 305 severely ill patients with COVID-19: a cohort study |
| title_sort | vascular complications in 305 severely ill patients with covid 19 a cohort study |
| topic | Mortality COVID-19 Cohort studies Peripheral vascular diseases Critical care Vascular complications SARS-CoV-2 infection Retrospective analysis 30-days follow-up |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005031296&tlng=en |
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