Assessing the stiffness of the arteries could help identify patients most at risk of dying from COVID-19, new research has revealed.

Researchers at Newcastle University (Newcastle, Tyne and Wear, UK) have shown that estimated pulse wave velocity (ePWV), a readily available marker of aortic stiffening, can be an effective addition in identifying patients at risk of death in hospital due to the SARS-CoV-2 virus. Accurate risk stratification at hospital admission of these patients is of utmost clinical importance as it is needed to guide therapeutic strategies.

ePWV is a measurement of arterial stiffness that is an independent predictor of cardiovascular risk. It can be measured simply and noninvasively by measuring the carotid and femoral pulse pressures, with sensors on the ankles and neck, and the time delay between the two or by other methods relying on pulse-wave analysis. The study carried out in two cohorts of hospitalized COVID-19 patients demonstrated that ePWV provides an additional clinical tool to refine risk stratification of hospitalized patients beyond established risk factors and scores. It was found that the addition of ePWV to clinical predictive markers or a validated mortality score improved the prognostic value for in-hospital mortality and therefore, could facilitate therapeutic decisions in acute COVID-19 disease.

The team found that the optimal prognostic ePWV value was 13.0 m/sec for predicting in-hospital mortality. When the total cohort of patients with COVID-19 was compared with the total control cohort, ePWV progressively increased across the controls, COVID-19 survivors and COVID-19 patients who didn’t survive after controlling for age, sex, hypertension and other relevant factors. ePWV was significantly higher in COVID-19 patients as compared to their non-COVID-19 counterparts.

The readily available measure of arterial stiffness when used in addition to tools already recommended in clinical practice may facilitate therapeutic decisions in acute COVID-19 disease. The team will be continuing further research in this area to develop the technique and seek its validation into health service practice.

“Our findings suggest that increased aortic stiffening may serve as a predictor of mortality in COVID-19 infection reflecting a cumulative surrogate of ageing and high-risk cardiovascular profile,” said Professor Stellos, Professor of Cardiovascular Medicine at Newcastle University and Heidelberg University. 

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