Key result
Higher carotid intima-media thickness at admission was associated with higher odds of death or mechanical ventilation in adults with non-severe COVID-19 pneumonia (OR ≥1.50).
Why the study?
To evaluate the association between carotid intima-media thickness at hospital admission and unfavorable outcomes in adults without advanced vascular diseases presenting with non-severe COVID-19 pneumonia.
Is higher carotid intima-media thickness associated with unfavorable outcomes in adults with non-severe COVID-19 pneumonia?
Case-Control (n=207)
Is higher carotid intima-media thickness associated with unfavorable outcomes in adults with non-severe COVID-19 pneumonia?
Effect estimate: OR ≥1.50 (95% CI lower limit ≥1.00 (99% CI))
Increased carotid intima-media thickness at admission may serve as a useful risk stratification tool for predicting severe outcomes in patients presenting with non-severe COVID-19 pneumonia.
CIMT at admission was associated with unfavorable outcomes in non-severe COVID-19; leaves open its value for risk stratification pending prospective validation.
AIM: To evaluate the association between carotid intima-media thickness (CIMT) at hospital admission and unfavorable outcomes in adults without advanced vascular diseases presenting with non-severe COVID-19 pneumonia to assess the feasibility of evaluating CIMT as a risk stratification aid in this setting. METHODS: This proof-of-concept nested case-control study enrolled consecutive non-vaccinated adults free of advanced vascular diseases presenting with verified non-severe COVID-19 pneumonia between December 2020 and June 2021. CIMT was measured at admission, and patients were managed in line with the national Ministry of Health guidelines. Those who died or required mechanical ventilation (MV) during the index hospital stay were considered cases and were matched (entropy balancing, exact matching) on a set of covariates to survivors not requiring MV (controls). Frequentist and Bayesian logistic models were fitted to the case status. RESULTS: The study enrolled 207 patients: 27 (13%) cases and 180 controls. All were retained in the analysis after entropy balancing, while 27 cases were exactly matched to 99 controls. Higher CIMT at the proximal internal carotid artery (both left and right) was consistently associated with higher odds of being a case: all odds ratio point-estimates were ≥1.50 with lower limits of the 99% confidence intervals/credibility intervals ≥1.00 with two-sided probabilities of OR>1.00 greater than 99.5%. The susceptibility of the estimates to unmeasured confounding was low. CONCLUSION: This study supports the feasibility of CIMT as a risk stratification aid in adults free of advanced vascular disease presenting with non-severe COVID-19 pneumonia.
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Crnjaković et al. (2023) conducted a case-control in non-severe COVID-19 pneumonia (n=207). Carotid intima-media thickness (CIMT) was evaluated on death or requirement for mechanical ventilation during the index hospital stay (OR ≥1.50, 95% CI lower limit ≥1.00 (99% CI)). Higher carotid intima-media thickness at admission was associated with higher odds of death or mechanical ventilation in adults with non-severe COVID-19 pneumonia (OR ≥1.50).
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