Retrospective analysis of clinical characteristics and outcomes of coronavirus disease 2019 critically ill patients with or without vascular calcification

Aim To analyze the differences in clinical characteristics and outcomes of coronavirus disease 2019 (COVID-19) critically ill patients with or without vascular calcification. Methods COVID-19 critically ill patients admitted to the intensive care unit of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in February 2020 were analyzed retrospectively. According to the chest CT findings, the patients were divided into vascular calcification group and non-vascular calcification group. The vascular calcification group was further divided into aortic calcification group, coronary calcification group and simultaneous calcification group (both aorta and coronary artery calcification). The clinical characteristics and outcomes of patients were compared in different groups. Results Compared with the non-vascular calcification group, the patients in the vascular calcification group were older and had a higher proportion of hypertension and coronary heart disease, which showed higher levels of leukocyte count, neutro-phil count, C-reactive protein, globulin, lactate dehydrogenase, international normalized ratio, D-dimer, creatinine, crea-tine kinase-MB, high-sensitivity cardiac troponin, myohemoglobin and N-terminal pro-B-type natriuretic peptide, lower levels of lymphocyte count, platelet count, albumin, estimated glomerular filtration rate, and higher risk of death. Compared with aortic calcification group, the outcomes of coronary calcification group and simultaneous calcification group were worse. Conclusion Vascular calcification, especially coronary artery calcification, may be a risk factor for poor prognosis in COVID-19 critically ill patients. © 2022, Editorial Office of Chinese Journal of Arteriosclerosis. All rights reserved.

Cross-Talks between the Cardiovascular Disease-Sarcopenia-Osteoporosis Triad and Magnesium in Humans.

Magnesium (Mg) is a pivotal and very complex component of healthy aging in the cardiovascular-muscle-bone triad. Low Mg levels and low Mg intake are common in the general aging population and are associated with poorer outcomes than higher levels, including vascular calcification, endothelial dysfunction, osteoporosis, or muscle dysfunction/sarcopenia. While Mg supplementation appears to reverse these processes and benefit the triad, more randomized clinical trials are needed. These will allow improvement of preventive and curative strategies and propose guidelines regarding the pharmaceutical forms and the dosages and durations of treatment in order to optimize and adapt Mg prescription for healthy aging and for older vulnerable persons with comorbidities.

The Role of Vitamin K in Humans: Implication in Aging and Age-Associated Diseases.

As human life expectancy is rising, the incidence of age-associated diseases will also increase. Scientific evidence has revealed that healthy diets, including good fats, vitamins, minerals, or polyphenolics, could have antioxidant and anti-inflammatory activities, with antiaging effects. Recent studies demonstrated that vitamin K is a vital cofactor in activating several proteins, which act against age-related syndromes. Thus, vitamin K can carboxylate osteocalcin (a protein capable of transporting and fixing calcium in bone), activate matrix Gla protein (an inhibitor of vascular calcification and cardiovascular events) and carboxylate Gas6 protein (involved in brain physiology and a cognitive decline and neurodegenerative disease inhibitor). By improving insulin sensitivity, vitamin K lowers diabetes risk. It also exerts antiproliferative, proapoptotic, autophagic effects and has been associated with a reduced risk of cancer. Recent research shows that protein S, another vitamin K-dependent protein, can prevent the cytokine storm observed in COVID-19 cases. The reduced activation of protein S due to the pneumonia-induced vitamin K depletion was correlated with higher thrombogenicity and possibly fatal outcomes in COVID-19 patients. Our review aimed to present the latest scientific evidence about vitamin K and its role in preventing age-associated diseases and/or improving the effectiveness of medical treatments in mature adults ˃50 years old.