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Estimated pulse wave velocity improves risk stratification for all-cause mortality in patients with COVID-19.
Stamatelopoulos, Kimon; Georgiopoulos, Georgios; Baker, Kenneth F; Tiseo, Giusy; Delialis, Dimitrios; Lazaridis, Charalampos; Barbieri, Greta; Masi, Stefano; Vlachogiannis, Nikolaos I; Sopova, Kateryna; Mengozzi, Alessandro; Ghiadoni, Lorenzo; van der Loeff, Ina Schim; Hanrath, Aidan T; Ajdini, Bajram; Vlachopoulos, Charalambos; Dimopoulos, Meletios A; Duncan, Christopher J A; Falcone, Marco; Stellos, Konstantinos.
  • Stamatelopoulos K; Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece. kstamatel@med.uoa.gr.
  • Georgiopoulos G; Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK. kstamatel@med.uoa.gr.
  • Baker KF; Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
  • Tiseo G; School of Biomedical Engineering and Imaging Sciences, King's College, London, UK.
  • Delialis D; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Lazaridis C; NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Barbieri G; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Masi S; Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
  • Vlachogiannis NI; Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
  • Sopova K; RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Mengozzi A; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Ghiadoni L; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • van der Loeff IS; Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
  • Hanrath AT; Biosciences Institute, International Centre for Life, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.
  • Ajdini B; RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
  • Vlachopoulos C; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Dimopoulos MA; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Duncan CJA; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Falcone M; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Stellos K; Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
Sci Rep ; 11(1): 20239, 2021 10 12.
Article in English | MEDLINE | ID: covidwho-1467128
ABSTRACT
Accurate risk stratification in COVID-19 patients consists a major clinical need to guide therapeutic strategies. We sought to evaluate the prognostic role of estimated pulse wave velocity (ePWV), a marker of arterial stiffness which reflects overall arterial integrity and aging, in risk stratification of hospitalized patients with COVID-19. This retrospective, longitudinal cohort study, analyzed a total population of 1671 subjects consisting of 737 hospitalized COVID-19 patients consecutively recruited from two tertiary centers (Newcastle cohort n = 471 and Pisa cohort n = 266) and a non-COVID control cohort (n = 934). Arterial stiffness was calculated using validated formulae for ePWV. ePWV progressively increased across the control group, COVID-19 survivors and deceased patients (adjusted mean increase per group 1.89 m/s, P < 0.001). Using a machine learning approach, ePWV provided incremental prognostic value and improved reclassification for mortality over the core model including age, sex and comorbidities [AUC (core model + ePWV vs. core model) = 0.864 vs. 0.755]. ePWV provided similar prognostic value when pulse pressure or hs-Troponin were added to the core model or over its components including age and mean blood pressure (p < 0.05 for all). The optimal prognostic ePWV value was 13.0 m/s. ePWV conferred additive discrimination (AUC 0.817 versus 0.779, P < 0.001) and reclassification value (NRI = 0.381, P < 0.001) over the 4C Mortality score, a validated score for predicting mortality in COVID-19 and the Charlson comorbidity index. We suggest that calculation of ePWV, a readily applicable estimation of arterial stiffness, may serve as an additional clinical tool to refine risk stratification of hospitalized patients with COVID-19 beyond established risk factors and scores.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / Vascular Stiffness / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-99050-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / Vascular Stiffness / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-99050-0