RESUMEN
BACKGROUND: SARS-CoV-2 is a systemic disease that affects endothelial function and leads to coagulation disorders, increasing the risk of mortality. Blood levels of endothelial biomarkers such as Von Willebrand Factor (VWF), Thrombomodulin or Blood Dendritic Cell Antigen-3 (BDCA3), and uUokinase (uPA) increase in patients with severe disease and can be prognostic indicators for mortality. Therefore, the aim of this study was to determine the effect of VWF, BDCA3, and uPA levels on mortality. METHODS: From May 2020 to January 2021, we studied a prospective cohort of hospitalized adult patients with polymerase chain reaction (PCR)-confirmed COVID-19 with a SaO2 ≤ 93% and a PaO2/FiO2 ratio < 300. In-hospital survival was evaluated from admission to death or to a maximum of 60 days of follow-up with Kaplan-Meier survival curves and Cox proportional hazard models as independent predictor measures of endothelial dysfunction. RESULTS: We recruited a total of 165 subjects (73% men) with a median age of 57.3 ± 12.9 years. The most common comorbidities were obesity (39.7%), hypertension (35.4%) and diabetes (30.3%). Endothelial biomarkers were increased in non-survivors compared to survivors. According to the multivariate Cox proportional hazard model, those with an elevated VWF concentration ≥ 4870 pg/ml had a hazard ratio (HR) of 4.06 (95% CI: 1.32-12.5) compared to those with a lower VWF concentration adjusted for age, cerebrovascular events, enoxaparin dose, lactate dehydrogenase (LDH) level, and bilirubin level. uPA and BDCA3 also increased mortality in patients with levels ≥ 460 pg/ml and ≥ 3600 pg/ml, respectively. CONCLUSION: The risk of mortality in those with elevated levels of endothelial biomarkers was observable in this study.
Asunto(s)
Biomarcadores , COVID-19 , Trombomodulina , Activador de Plasminógeno de Tipo Uroquinasa , Factor de von Willebrand , Humanos , COVID-19/mortalidad , COVID-19/sangre , Masculino , Factor de von Willebrand/metabolismo , Factor de von Willebrand/análisis , Persona de Mediana Edad , Femenino , Biomarcadores/sangre , Anciano , Activador de Plasminógeno de Tipo Uroquinasa/sangre , Trombomodulina/sangre , Estudios Prospectivos , Pronóstico , SARS-CoV-2 , Adulto , Endotelio Vascular/fisiopatología , Mortalidad Hospitalaria , Modelos de Riesgos ProporcionalesRESUMEN
BACKGROUND & AIMS: The deterioration of pulmonary function has been associated with increased levels of systemic inflammation that can be stimulated by consumption of saturated fatty acids and trans fats. We hypothesized that fatty acids intake impact on pulmonary function. However, evidence about the impact of different types of fatty acids on pulmonary function in patients with chronic obstructive pulmonary disease (COPD) is limited and heterogeneous. The aim of this study was to evaluate the association between intake of fatty acids and pulmonary function in patients with COPD. METHODS: Cross sectional study of patients diagnosed with COPD. The relationship between consumption of fatty acids and the FEV1/FVC ratio obtained by spirometry was assessed. Patients with exacerbations during the prior 2 months, diagnosis of asthma or administration of a dietary supplement were excluded. RESULTS: A simple linear regression showed that for each gram of carbohydrates and total l fatty acids intake, the FEV1/FVC ratio decreased -0.03 ml (ß: -0.03, 95% CI -0.06 to -0.01, p = 0.008) and -0.009 ml (ß: -0.00, 95% CI -0.02 to 0.00, p = 0.031) respectively. Pentadecanoic acid (C15:0) was associated with an increase of 0.47 ml in the FEV1/FVC ratio for each milligram intake (ß: 0.47, 95% CI 0.04 to 0.91, p = 0.031). Subsequently, when adjusted for calories intake, an increase of 0.53 ml was observed in the FEV1/FVC for each milligram of C15:0 fatty acid intake (ß:0.53, 95% CI 0.09 to 0.97, p = 0.018). CONCLUSION: A positive association was observed between pentadecanoic acid and the FEV1/FVC ratio with a beneficial effect on patients with COPD.