• Rebeca Mangabeira Correia, Brena Costa Santos, Ana Alyra Garcia Carvalho, Libnah Leal Areias, Danielle Akemi Bergara Kuramoto, Mariana Raffo Pereda, Ana Laura E Silva Aidar, Caroline Nicacio Bessa Clezar, Marcello Erich Reicher, Jorge Eduardo de Amorim, Ronald Luiz Gomes Flumignan, and Luis Carlos Uta Nakano.
• MD. Master's Student, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), São Paulo, Brazil.
• Sao Paulo Med J. 2022 Jan 1; 141 (5): e2022171e2022171.

BackgroundAlthough an association has been made between coronavirus disease 2019 (COVID-19) and microvascular disease, data on vascular complications (other than venous thromboembolism) are sparse.ObjectiveTo investigate the vascular complications in severely ill patients hospitalized with COVID-19 and their association with all-cause mortality.Design And SettingThis cohort study was conducted at the Universidade Federal de São Paulo, Brazil.MethodsAll 305 consecutive patients diagnosed with COVID-19 and hospitalized in the intensive care unit (ICU) of a tertiary university hospital from April 2 to July 17, 2021, were included and followed up for 30 days.ResultsOf these, 193 (63.3%) were male, and the mean age was 59.9 years (standard deviation = 14.34). The mortality rate was 56.3% (172 patients), and 72 (23.6%) patients developed at least one vascular complication during the follow-up period. Vascular complications were more prevalent in the non-survivors (28.5%) than in the survivors (17.3%) group and included disseminated intravascular coagulation (DIC, 10.8%), deep vein thrombosis (8.2%), acrocyanosis (7.5%), and necrosis of the extremities (2%). DIC (adjusted odds ratio (aOR) 2.30, 95% confidence interval (CI) 1.01-5.24, P = 0.046) and acrocyanosis (aOR 5.21, 95% CI 1.48-18.27, P = 0.009) were significantly more prevalent in the non-survivors than in the survivors group.ConclusionVascular complications in critically ill COVID-19 patients are common (23.6%) and can be closely related to the mortality rate (56.3%) until 30 days after ICU admission. Macrovascular complications have direct implications for mortality, which is the main outcome of the management of COVID-19.RegistrationRBR-4qjzh7 (https://ensaiosclinicos.gov.br/rg/RBR-4qjzh7).

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