ABSTRACT
Objective: Up to date the possibility of a vascular damage due to COVID-19 pneumonia is a not clarified. We searched for relationships between the carotidfemoral pulse wave velocity (cfPWV) and clinical and biochemical markers of severity of the infectious disease, after hospital discharge, in a group of patients who had been admitted in care units. Design and method: In 69 subjects (age 58 ± 13 years, 36 males), previously admitted in hospital because of COVID-19 pneumonia, we evaluated at the time of hospital admission anthropometric parameters, blood pressure, history of arterial hypertension or other diseases, drugs, smoking and alcohol habit, physical activity level, and indexes of infectious disease severity, such as the SIMEU score, need for invasive oxygen delivery, PaO2, PaCo2, inflammatory markers such as white blood cells count, levels of proadrenomedulline (proADM), reactive C protein, procalcitonin, IL- 6, glomerular filtration rate (GFR), troponin, mioglobin, B natriuretic peptide. After an average 2 months follow-up the cf- PWV was measured. Results: At univariate analysis the cfPWV was significantly and positively related to age (r = 0.454, P < 0.001), body mass index (r = 0.436, P = 0.016), waist circumference (r = 0.345, P = 0.004), levels of plasma glucose (r = 0.430, P = 0.001), proADM (r = 0.456, P = 0.006), IL-6 (r = 0.280, P = 0.037), mioglobin (r = 0.443, P = 0.001) and inversely related to GFR (r = -0.289, P = 0.023). The cfPWV was higher in diabetics subjects than in non-diabetics (P = 0.011), and in patients who had needed invasive oxygen support (P = 0.044). There was no difference in cfPWV in patients with or without history of arterial hypertension or with different blood pressure levels at admission. At multivariate analysis the cfPWV was independently associated with invasive oxygen support (B = 0.168, P = 0.012), body mass index (B = 0.180, P = 0.001), waist circumference (B = 0.162, P = 0.002), GFR (B = 0.078, P = 0.008), and proADM levels (B = 0.161, P = 0.003). Conclusions: In patients who recovered from COVID-19 pneumonia the aortic stiffness is associated with severity of disease and levels of proADM, but not with history of hypertension. Patients with more higher proADM levels in acute phase of the infectious disease could need a longer follow-up evaluation of the CFPWV after the recovering from disease to search for long time vascular damage.
ABSTRACT
Purpose: The purpose of this article is to understand how coronavirus impacts relate to existing vulnerabilities in different world regions. Design/methodology/approach: The article utilizes quantitative analysis to examine regional variations in coronavirus risk assessment. It then qualitatively employs a policy coherence for development (PCD) approach to analyze how public policies contribute to or mitigate vulnerability, defined as the product of exposure to external shocks, institutional coping capabilities and risk associated with social divisions in societies. Findings: The research presented below shows that significant regional variance exists in terms of coronavirus risk, based on statistical analysis of the INFORM COVID-19 Risk Report prepared by the European Commission. The PCD analysis highlights important relationships between public policy strategies and the construction of both underlying vulnerabilities and coronavirus impacts. Practical implications: The PCD approach presented here focuses on the reconciliation of trade-offs. It shows how policy interactions affect vulnerabilities and suggests that coherent policy strategies aimed at reducing vulnerabilities are necessary in order to adequately respond to the coronavirus pandemic. Originality/value: This analysis frames vulnerability as a socially constructed condition and through implementation of a PCD approach, it indicates how policy strategies contribute to or mitigate vulnerabilities. In doing so, it intends to contribute conceptually to the literature on vulnerability by showing how policy incoherences contribute to the construction of this condition. Empirically, the originality of this article is its statistical analysis of regional variance of coronavirus risk and the qualitative analysis of policy strategies in representative cases and how they have affected vulnerabilities and coronavirus impacts. © 2021, Emerald Publishing Limited.