Endothelial function, arterial stiffness and heart rate variability of patients with cardiovascular diseases hospitalized due to COVID-19.
Cláudia Regina da Silva Araújo, Juliana Fernandes, Débora Sidrônio Caetano and 8 others
PMID 36621104WHAT IT FOUND
51.8% of 27 hospitalized patients with cardiovascular disease and stage II COVID-19 had endothelial dysfunction.
The dysfunction group had a higher heart-rate variability component linked to parasympathetic activity. This is a small observational study, not evidence that treating it changes outcomes.
Key findings
0114 of 27 analyzed patients (51.8%) had endothelial dysfunction.
02Patients with endothelial dysfunction had a lower median LnRHI than those with preserved function (0.29 [0.06 to 0.42] vs 0.58 [0.54 to 0.88]; p < 0.01).
03In the endothelial dysfunction group, HF HRV was higher than in the preserved group (216.1 [160.8-271.5] vs 125.9 [55.8-196] ms²; p = 0.03) and correlated negatively with LnRHI (r = -0.35; p = 0.01).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 27 patients were analyzed after many exclusions, so the study is small and may not represent other patients. Endothelial function and arterial stiffness were not measured before COVID-19 or after discharge, so it cannot show whether the changes were caused by COVID-19 or persisted after hospitalization. Most sample loss happened because RT-PCR results were delayed; 203 eligible patients could not be assessed early. Patients had pre-existing cardiovascular disease, especially hypertension and heart failure, and these conditions could explain the vascular findings. There was no intervention, control group, or follow-up outcome that tested whether monitoring or treating these changes helps patients. The arterial stiffness finding was hard to interpret: the paper says lower AIx reflects better elasticity, but reports lower AIx@75 in the dysfunction group and still suggests high stiffness there.
Declared interests
The work was funded by Brazilian university and research agencies. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that endothelial dysfunction caused adverse cardiac events or that finger-cuff monitoring improves outcomes. The study was cross-sectional, had no pre-COVID or follow-up assessment, and the adverse event difference was not statistically significant (p = 0.07).