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Vascular complications in 305 severely ill patients with COVID-19: a cohort study
Correia, Rebeca Mangabeira; Santos, Brena Costa; Carvalho, Ana Alyra Garcia; Areias, Libnah Leal; Kuramoto, Danielle Akemi Bergara; Pereda, Mariana Raffo; Aidar, Ana Laura e Silva; Clezar, Caroline Nicacio Bessa; Reicher, Marcello Erich; Amorim, Jorge Eduardo de; Flumignan, Ronald Luiz Gomes; Nakano, Luis Carlos Uta.
  • Correia, Rebeca Mangabeira; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Santos, Brena Costa; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Carvalho, Ana Alyra Garcia; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Areias, Libnah Leal; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Kuramoto, Danielle Akemi Bergara; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Pereda, Mariana Raffo; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Aidar, Ana Laura e Silva; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Clezar, Caroline Nicacio Bessa; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Reicher, Marcello Erich; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Amorim, Jorge Eduardo de; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Flumignan, Ronald Luiz Gomes; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
  • Nakano, Luis Carlos Uta; Universidade Federal de São Paulo (UNIFESP). Division of Vascular and Endovascular Surgery. São Paulo. BR
São Paulo med. j ; 141(5): e2022171, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1432460
ABSTRACT
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).


Full text: Available Index: LILACS (Americas) Type of study: Etiology study / Observational study / Risk factors Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2023 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de São Paulo (UNIFESP)/BR

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Full text: Available Index: LILACS (Americas) Type of study: Etiology study / Observational study / Risk factors Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2023 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de São Paulo (UNIFESP)/BR