Cardiovascular drugs and analysis of potential risk factors associated with mortality in severe coronavirus disease 2019 patients.

OBJECTIVES: Cardiovascular diseases are also considered to increase the risk of death in COVID-19 patients. However, real-world data concerning the risk factors for death in patients with severe COVID-19 still remain vague. This study aimed to identify the potential risk factors associated with mortality in severe COVID-19 patients. METHODS: All consecutive patients admitted to the intensive care unit (ICU) of our institute for COVID-19 for severe COVID-19 pneumonia from April 1, 2020 to July 20, 2020 were included in the analysis. Patient characteristics, including complete medical history and comorbid diseases, blood test results during admission and on day 7, and clinical characteristics were compared between survivors and nonsurvivors. RESULTS: There was no significant difference between survivors and nonsurvivors regarding age, gender, and preexisting cardiovascular diseases. Moreover, the rate of the medications including angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockers did not differ between survivors and nonsurvivors. The peak C-reactive protein (CRP), procalcitonin, fibrinogen, and d-dimer levels and the rate for chronic renal failure were significantly higher in nonsurvivors compared with survivors. Intubated patients had a higher risk of death than the others had. CONCLUSIONS: This study failed to demonstrate a significant difference in preexisting cardiovascular diseases and cardiovascular medications between survivors and nonsurvivors who were admitted to ICU for severe COVID-19. Our findings indicate that the presence of chronic renal failure, a high peak ferritin concentration, and the need for invasive mechanical ventilation appear predictive for mortality. We propose that these risk factors should be taken into account in defining the risk status of severe COVID-19 patients admitted to the ICU.

Evaluation of Epicardial Adipose Tissue by Echocardiography and Its Correlation with Aortic Velocity Propagation and Carotid Intima-Media Thickness in Patients of Type 2 Diabetes Mellitus.

Epicardial fat thickness (EFT) is associated with aortic stiffness in diabetic patients. In this study, we aimed to determine if there is an association among the parameters of EFT, aortic velocity propagation (AVP), and carotid intima-media thickness (CIMT) in patients with non-insulin dependent diabetes mellitus. This study included 55 non-insulin dependent diabetes mellitus patients and 40 non-diabetic control patients. For all participants, EFT and AVP were determined by echocardiographic method and CIMT was calculated using an ultrasonographic exam. The EFT and CIMT values were found to be significantly increased in the non-insulin dependent diabetes mellitus group. On the other hand, aortic velocity propagation was decreased in the non-insulin dependent diabetes mellitus group compared to non-diabetic patients (EFT; 8.43 ± 1.68 versus 6.36 ± 2.21 mm, p < 0.001; CIMT; 0.92 ± 0.24 versus 0.58 ± 0.18 mm, p < 0.001; and AVP; 28.20 ± 16.02 versus 58.10 ± 17.50, p < 0.01, respectively). Significantly higher EFT and CIMT values were found in addition to lower AVP values in non-insulin dependent diabetes mellitus patients. Moreover, we demonstrated that there was a strong correlation between EFT, CIMT, and AVP.