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Clinical Assessment of Endothelial Function in Convalescent COVID-19 Patients Undergoing Multidisciplinary Pulmonary Rehabilitation.
Ambrosino, Pasquale; Molino, Antonio; Calcaterra, Ilenia; Formisano, Roberto; Stufano, Silvia; Spedicato, Giorgio Alfredo; Motta, Andrea; Papa, Antimo; Di Minno, Matteo Nicola Dario; Maniscalco, Mauro.
  • Ambrosino P; Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
  • Molino A; Department of Respiratory Medicine, Federico II University, 80131 Naples, Italy.
  • Calcaterra I; Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
  • Formisano R; Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
  • Stufano S; Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
  • Spedicato GA; Department of Data Analytics and Actuarial Science, Unipol Group, 40128 Bologna, Italy.
  • Motta A; Institute of Biomolecular Chemistry, National Research Council, ICB-CNR, 80078 Pozzuoli, Naples, Italy.
  • Papa A; Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
  • Di Minno MND; Department of Translational Medical Sciences, Federico II University, 80131 Naples, Italy.
  • Maniscalco M; Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy.
Biomedicines ; 9(6)2021 May 28.
Article in English | MEDLINE | ID: covidwho-1256426
ABSTRACT

BACKGROUND:

Growing evidence points to a key role of endothelial dysfunction in the pathogenesis of COVID-19. In this study, we evaluated changes in endothelium-dependent flow-mediated dilation (FMD) in a cohort of convalescent COVID-19 patients undergoing pulmonary rehabilitation (PR).

METHODS:

After swab test negativization, convalescent COVID-19 patients referring to a post-acute care facility for PR were consecutively screened for inclusion. Study procedures were performed at the time of hospitalization and discharge.

RESULTS:

We enrolled 82 convalescent COVID-19 patients (85.4% males, mean age 60.4 years). After PR, a significant improvement in most pulmonary function tests and exercise capacity was documented. FMD changed from 2.48% ± 2.01 to 4.24% ± 2.81 (p < 0.001), corresponding to a 70.9% increase. Significantly higher changes in FMD were found in patients without a history of vascular events as compared to those with (+2.04% ± 2.30 vs. +0.61% ± 1.83, p = 0.013). Values of forced expiratory volume in 1 s (FEV1%), forced vital capacity (FVC%) and diffusion capacity for carbon monoxide (DLCO%) significantly and directly correlated with FMD both at baseline and after PR. Patients with normal FEV1% (≥80% predicted) during the overall study period or those normalizing FEV1% after PR showed a more significant FMD change as compared to patients with persistently impaired FEV1% (<80% predicted) (p for trend = 0.029). This finding was confirmed in a multivariate analysis.

CONCLUSIONS:

Clinically evaluated endothelial function improves after PR in convalescent COVID-19 patients. A direct and persistent association between the severity of pulmonary and vascular disease can be hypothesized. Endothelial function testing may be useful in the follow-up of convalescent COVID-19 patients.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Biomedicines9060614

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Biomedicines9060614