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Aims: COVID-19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID-19 inpatients.Materials and Methods: We prospectively and consecutively enrolled COVID-19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow-up time was 30 days from hospital admission.Results: We enrolled 132 subjects (55.0-75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260-per 1 cm increase 95% CI:1.120-1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m2 (adjusted OR 1.526; 95% CI:1.243-1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684-0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log-rank test: P < .001).Conclusions: NC is an easy to measure parameter able to predict the need for IMV in adult COVID-19 inpatients. [ABSTRACT FROM AUTHOR]

Hypertensive subjects can be subdivided into 2 groups, dippers and nondippers, according to the presence or the lack of a nocturnal fall of blood pressure of more than 10%. Several studies have investigated cardiac organ damage in the 2 groups with discordant results, but they included subjects with different onset, severity, and treatment of hypertension. The authors selected 23 dippers and 17 nondippers affected by newly (< 1 year) diagnosed grades 1 and 2 hypertension, never treated, who underwent 24-hour ambulatory blood pressure monitoring and M-mode echocardiography. They did not find significant differences between the 2 groups as regards the echocardiographic left ventricular and atrial dimensions or regarding the left ventricular mass, left ventricular mass index, or relative wall thickness. Also no significant differences were found in the rate of either left ventricular remodeling or left ventricular hypertrophy. These data suggest that nondipping status is not associated with a higher level of cardiac involvement in the early phases of hypertension compared to dipping status. [ABSTRACT FROM AUTHOR]