• Scientific reports · Oct 2021

    Estimated pulse wave velocity improves risk stratification for all-cause mortality in patients with COVID-19.

    • Kimon Stamatelopoulos, Georgios Georgiopoulos, Kenneth F Baker, Giusy Tiseo, Dimitrios Delialis, Charalampos Lazaridis, Greta Barbieri, Stefano Masi, Nikolaos I Vlachogiannis, Kateryna Sopova, Alessandro Mengozzi, Lorenzo Ghiadoni, Ina Schim van der Loeff, Aidan T Hanrath, Bajram Ajdini, Charalambos Vlachopoulos, Meletios A Dimopoulos, DuncanChristopher J ACJATranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.RVI and Freeman Hospitals, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK., Marco Falcone, Konstantinos Stellos, Pisa COVID-19 Research Group, and Newcastle COVID-19 Research Group.
    • Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece. kstamatel@med.uoa.gr.
    • Sci Rep. 2021 Oct 12; 11 (1): 20239.

    AbstractAccurate 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.© 2021. The Author(s).

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