Walia Rohit, Arunachalam Venkat Subaih, Chauhan Udit, Khapre Meenakshi, Arora Poonam
Department of Cardiology, All India Institute of Medical Science Rishikesh, Uttarakhand, India.
Radiology, All India Institute of Medical Science Rishikesh, Uttarakhand, India.
J Family Med Prim Care. 2022 Jan;11(1):319-324. doi: 10.4103/jfmpc.jfmpc_281_21. Epub 2022 Jan 31.
Endothelial dysfunction, inflammation, and hypercoagulability are hallmarks of severe COVID-19 related disease. Endothelial function can be measured non-invasively by flow-mediated dilatation in the brachial artery. We planned a study to measure it as a marker of the severity of COVID-19 disease.
To evaluate the association of clinically recognizable endothelial dysfunction in COVID-19 disease and its usefulness as a marker of severe COVID-19-related disease.
20 COVID-19 patients being admitted to our unit were analyzed for endothelial dysfunction and correlated with disease severity as per computed tomography (CT) chest score. Patients with diabetes, atherosclerotic coronary artery disease, dyslipidemia, chronic renal disease, and infections other than COVID-19 were excluded. Endothelial dysfunction was measured by flow-mediated dilatation in the brachial artery.
The mean age was 46.4 ± 16.5 years; 70% were males. The mean CT severity score was 22 ± 8; 60% required supplemental oxygen and steroids. The incidence of endothelial dysfunction was more in patients with a computed tomography severity score of >19.5 or oxygen saturation of <93% at room air as compared to mild cases ( = 0.003). Endothelial dysfunction was more evident >7 days after onset of disease as compared to early (<7 days) disease ( = 0.016). There was negative correlation between % flow-mediated dilatation in brachial artery and severity of lung involvement and prolonged symptomatic phase.
Endothelial dysfunction as measured by impaired brachial artery flow mediated dilatation correlates with disease severity.
内皮功能障碍、炎症和高凝状态是重症新型冠状病毒肺炎（COVID-19）相关疾病的特征。可通过肱动脉血流介导的血管舒张功能进行无创测量内皮功能。我们计划开展一项研究，将其作为COVID-19疾病严重程度的标志物进行测量。
评估COVID-19疾病中临床上可识别的内皮功能障碍的相关性及其作为重症COVID-19相关疾病标志物的实用性。
对入住我科的20例COVID-19患者进行内皮功能障碍分析，并根据胸部计算机断层扫描（CT）评分与疾病严重程度进行相关性分析。排除患有糖尿病、动脉粥样硬化性冠状动脉疾病、血脂异常、慢性肾脏疾病以及COVID-19以外感染的患者。通过肱动脉血流介导的血管舒张功能测量内皮功能障碍。
平均年龄为46.4±16.5岁；70%为男性。平均CT严重程度评分为22±8；60%的患者需要补充氧气和使用类固醇。与轻症病例相比，计算机断层扫描严重程度评分>19.5或静息状态下血氧饱和度<93%的患者内皮功能障碍发生率更高（P=0.003）。与疾病早期（<7天）相比，疾病发作>7天后内皮功能障碍更明显（P=0.016）。肱动脉血流介导的血管舒张百分比与肺部受累严重程度和症状持续期呈负相关。
通过肱动脉血流介导的血管舒张功能受损测量的内皮功能障碍与疾病严重程度相关。
