People with relatively similar types of cardiovascular diseases may have different survival rates depending on when they test positive for the new coronavirus, new research suggests.
Treatment with vasopressin, a blood ingredient found in red blood cells, can predict how likely patients are likely to die and how high they will go into a sudden cardiac arrest within 72 hours, researchers report in the Health Behavior Journal.
The findings are drawn from nearly 1,800 patients without symptoms who had been treated with vasopressin or were admitted to intensive care units with symptoms of COVID-19, said lead study author Shannon Oddy of Liverpool John Moores University in the UK.
“Patients with a lower risk of having such a sudden cardiac arrest may require more intensive monitoring and possibly more simultaneous tests to achieve predictive outcomes,” Oddy said by email.
The benefits of vasopressin are prevented if the patient has angina, a sudden cardiac arrest caused by a blockage in the major blood flow to the heart, and is extremely distressing in the short term.
Vasopressin is used to treat patients with severe chronic heart failure, heart cancer, diabetes or older patients with end-stage renal disease and medically necessary procedures.
At 6 days post-surgery, short-term history of these events was associated with a 24% lower likelihood of mortality and a 23% lower likelihood of heart failure, meaning patients treated with vasopressin lived for about 12 months longer, the study found. Longer-term survival was similar to direct comparison for patients who received vasopressin vs who did not.
Patients who had consensus biomarkers of COVID severity were 94% less likely to have a sudden cardiac arrest within 72 hours, the study found.
Longer pleural extension was associated with a 16% lower likelihood of death, meaning patients with narrow pleural spaces were 54% more likely to die from COVID-19, and those with large pleural-like structures were 70% more likely to die.
Patients whose lab tests indicated treatment with vasopressin had 72% lower odds of dying after 10 months, and the pattern was more pronounced in individuals with preexisting pathologies, researchers found.
The findings were drawn from a cohort of 12,175 patients with severe coronavirus infections. Hemoglobin A1c levels were measured before and after vasopressin treatment, and patients were followed until at least 12 months.
Many patients had higher risk factors that were not adequately controlled by current treatments, researchers noted. They included cancer, hypertension and diabetes, some with preexisting heart conditions.
Between April and May, all procedures involving the kidneys were done with vasopressin, including colonoscopy, cholecystectomy, vasostatin therapy or bypass surgery.
In the vasopressin group, long-term survival was slightly better, at about 12 months, compared with 10 months for patients treated with oral medication or a beta blocker drug called dalteparin.
The study wasn’t a controlled experiment designed to prove whether or how vasopressin was directly involved in predicting patient outcomes. This doesn’t necessarily mean that patients who were treated with vasopressin had the same outcomes, the study authors note.
Future studies will need to do additional in-depth analysis to show what happens to patients treated with vasopressin compared with more traditional biomarkers of COVID-19 such as hemoglobin A1c levels and electrolytes, they add.
“Vasopressin is currently recommended in patients with heart failure for short-term use as a preventative measure and component component of cardiovascular surgery in the setting of heart failure progression,” wrote Dr. Tyler Clengard, a researcher at the University of California, San Francisco, in an email.
