Many individuals who had COVID-19 develop detrimental persistent symptoms; a condition known as post-acute sequelae of COVID-19 (PASC). Despite the elevated risk of cardiovascular disease following COVID-19, limited studies have examined vascular function in PASC with equivocal results reported. Moreover, the role of PASC symptom burden on vascular health has not been examined. We tested the hypothesis that peripheral and cerebral vascular function would be blunted, and central arterial stiffness would be elevated in patients with PASC compared to age-matched controls. Furthermore, we hypothesized that impairments in vascular health would be greater in those with higher PASC symptom burden. Resting blood pressure (BP; brachial and central), brachial artery flow-mediated dilation (FMD), forearm reactive hyperemia, carotid-femoral pulse wave velocity (PWV), and cerebral vasodilator function were measured in 12 females with PASC and 11 age matched female controls without PASC. The severity of persistent symptoms in those with PASC was reported on a scale of 1-10 (higher score: greater severity). Brachial BP (e.g., systolic BP, 126±19 vs.109±8 mmHg; P=0.010), central BP (P<0.050) and PWV (7.1±1.2 vs. 6.0±0.8 m/s; P=0.015) were higher in PASC compared to controls. However, FMD, reactive hyperemia, and cerebral vasodilator function were not different between groups (P>0.050 for all). Total symptom burden was not correlated with any measure of cardiovascular health (P>0.050 for all). Collectively, these findings indicate that BP and central arterial stiffness are elevated in females with PASC, whereas peripheral and cerebral vascular function appear to be unaffected; effects that appear independent of symptom burden.

Background:In COVID-19 survivors, symptom burden is a significant and multifaceted personal and societal challenge. The Omaha system is a standardized terminology used by researchers and clinicians for documentation and analysis of meaningful data for whole-person health. Given the urgent need for a standardized symptom checklist specific to the long COVID population, the purpose of the present study was to identify long COVID symptoms from the published literature (native symptoms) and map those to the Omaha system signs/symptoms terms.Methods:The long COVID symptoms identified from 13 literatures were mapped to the Omaha system signs/symptoms, using an expert consensus approach. The criteria for mapping were that the long COVID signs/symptoms had to contain either a one-to-one match (exact meaning of the native terms and the signs/symptoms) or a partial match (similar but not exact meaning).Results:The synthesis of the 217 native symptoms of long COVID and mapping analysis to the Omaha problems and signs/symptoms level resulted in a combined, deduplicated, and standardized list of 74 signs/symptoms for 23 problems. Of these, 72 (97.3%) of native signs/symptoms were a full match at the problem level, and 67 (90.5%) of native signs/symptoms were a full or partial match at the sign/symptoms level.Conclusions:The present study is the first step in identifying a standardized evidence-based symptom checklist for long COVID patients. This checklist may be used in practice and research for assessment, tracking, and intervention planning as well as longitudinal analysis of symptom resolution and intervention effectiveness.