ABSTRACT
Objective. To study the changes in the vascular wall, vascular age and metabolic parameters in polymorbid COVID-19 conva-lescents. Material and methods. The study included 62 patients with hypertension who reached the target blood pressure (BP) with dual an-tihypertensive therapy after severe and extremely severe COVID-19. The following examinations were performed: laboratory tests of metabolic parameters, assessment of changes in the vessel elasticity indices (pulse-wave velocity (PWV), augmentation index (AI), central systolic BP (cSBP), 24-hour BP monitoring, and non-invasive markers of liver fibrosis. Results. According to office BP measurements, after the coronavirus infection, an increase in systolic BP (SBP) by 29.6% and di-astolic BP (DBP) by 23.6%, as well as heart rate (HR) by 11.8% (p<0.05) was reported during regular antihypertensive therapy. In addition, 24-hour BP monitoring data indicated an increase in the average daily SBP, DBP, and heart rate. After the coronavirus infection, an increase in PWV by 35.4% (p<0.05), AI by 24.4% (p<0.05), cSBP by 22.1% were reported. Carbohydrate and lipid metabolism parameters deteriorated. A pronounced adverse effect of coronavirus infection on liver function was observed. The vascular age (according to the modified SCORE scale) increased by 6 years (p<0.05). Conclusion. Our study showed that patients after severe and extremely severe COVID-19 have a high risk of liver fibrosis, hypertension and lipid metabolism control worsening and accelerating vascular aging.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Objective. To study the changes in the vascular wall, vascular age and metabolic parameters in polymorbid COVID-19 conva-lescents. Material and methods. The study included 62 patients with hypertension who reached the target blood pressure (BP) with dual an-tihypertensive therapy after severe and extremely severe COVID-19. The following examinations were performed: laboratory tests of metabolic parameters, assessment of changes in the vessel elasticity indices (pulse-wave velocity (PWV), augmentation index (AI), central systolic BP (cSBP), 24-hour BP monitoring, and non-invasive markers of liver fibrosis. Results. According to office BP measurements, after the coronavirus infection, an increase in systolic BP (SBP) by 29.6% and di-astolic BP (DBP) by 23.6%, as well as heart rate (HR) by 11.8% (p<0.05) was reported during regular antihypertensive therapy. In addition, 24-hour BP monitoring data indicated an increase in the average daily SBP, DBP, and heart rate. After the coronavirus infection, an increase in PWV by 35.4% (p<0.05), AI by 24.4% (p<0.05), cSBP by 22.1% were reported. Carbohydrate and lipid metabolism parameters deteriorated. A pronounced adverse effect of coronavirus infection on liver function was observed. The vascular age (according to the modified SCORE scale) increased by 6 years (p<0.05). Conclusion. Our study showed that patients after severe and extremely severe COVID-19 have a high risk of liver fibrosis, hypertension and lipid metabolism control worsening and accelerating vascular aging.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Purpose: Immunomodulatory and anti-inflammatory properties have been hypothesized for native vitamin D (nVD). Very little is reported about nVD and risk of Sars- CoV-2 infection (COV) in renal transplant (RTx). In a cohort of renal transplanted patients (RTxp) we retrospectively evaluated: a) nVD status in patients with (COV+) and without (COV-) COV infection;b) the impact of nVD status on severity of COV. Method(s): The study includes 61 COV+ in whom nVD status was available in the year before the infection, and 122 COV- matched 1:2 for age (53[45-64]years), gender (M=60.7%), RTx vintage (7[2-15]years), presence of diabetes (18%), arterial hypertension (85%) and cardiac symptomatic disease (3%). Renal function, 24-h proteinuria, mineral metabolism (MM) parameters were evaluated at 1, 6 and 12 months before COV whereas nVD status was considered as the mean 25-OH-VD levels at the same timepoints. Severity of COV was based on the need for hospitalization (HOSP+: 27/61, 44.3%) and death (D+: 6/61, 9.8%). Result(s): a) nVD levels were significantly lower in COV+ than in COV- (19[12-26] ng/mL and 23[16-30] ng/mL, respectively, p=0.01). No differences in the other biochemical parameters were found. The COV discriminative power of nVD status was evaluated by ROC curve (AUC 0.61, 95% CI 0.54-0.68, p=0.01), with a value of 25-OHVD 23.9 ng/mL showing the best discriminative power (sensibility 72%, specificity 47%).b) nVD levels showed a trend towards lower values in HOSP+COV+ than HOSP-COV+ (17[8-25] ng/mL vs 20[14-26] ng/mL) and in D+COV+ than D-COV+ (13[6-23] ng/mL vs 20[13-26] ng/mL), although these differences did not reach the statistical significance (p=0.1 and p=0.2, respectively). Conclusion(s): With the limitations of the retrospective nature of the study and the small sample size, our data report that:COV+ showed lower nVD levels in the year preceding the infection compared to controls with similar main demographic features and comorbid conditionsNo differences were found in renal function, proteinuria, and other MM parameters between the two groupsNo association was found between nVD levels in the year preceding the infection and COV severity.
ABSTRACT
BACKGROUND AND AIMS: Immunomodulatory and anti-inflammatory properties have been hypothesized for native vitamin D (nVD). Very little is reported about nVD and risk of Sars-CoV-2 infection (COV) in renal transplant (RTx). In a cohort of renal transplanted patients (RTxp) we retrospectively evaluated: (i) nVD status in patients with (COV+) and without (COV-) COV infection;(ii) the impact of nVD status on severity of COV. METHOD: The study includes 61 COV + in whom nVD status was available in the year before the infection, and 122 COV- matched 1:2 for age (53[45-64]years), gender (M = 60.7%), RTx vintage (7[2-15] years), presence of diabetes (18%), arterial hypertension (85%) and cardiac symptomatic disease (3%). Renal function, 24-h proteinuria and mineral metabolism (MM) parameters were evaluated at 1, 6 and 12 months before COV whereas nVD status was considered as the mean 25- OH-VD levels at the same timepoints. Severity of COV was based on the need for hospitalization (HOSP+: 27/61, 44.3%) and death (D+: 6/61, 9.8%). RESULTS: (i) nVD levels were significantly lower in COV + than in COV- (19[12- 26] ng/mL and 23[16-30] ng/mL, respectively, P = 0.01). No differences in the other biochemical parameters were found. The COV discriminative power of nVD status was evaluated by ROC curve (AUC 0.61, 95% CI: 0.54-0.68, P = 0.01), with a value of 25-OHVD 23.9 ng/mL showing the best discriminative power (sensibility 72%, specificity 47%). (ii) nVD levels showed a trend towards lower values in HOSP + COV + than HOSP-COV+ (17[8-25] ng/mL versus 20[14-26] ng/mL) and in D + COV + than D-COV+ (13[6-23] ng/mL versus 20[13-26] ng/mL), although these differences did not reach the statistical significance (P = 0.1 and P = 0.2, respectively). CONCLUSION: With the limitations of the retrospective nature of the study and the small sample size, our data report that: (i) COV + showed lower nVD levels in the year preceding the infection compared with controls with similar main demographic features and comorbid conditions (ii) No differences were found in renal function, proteinuria and other MM parameters between the two groups. No association was found between nVD levels in the year preceding the infection and COV severity.