A pilot study: Exploring the influence of COVID-19 on cardiovascular physiology and retinal microcirculation

Salon, Adam; Neshev, Ruslan; Teraž, Kaja; Šimunič, Boštjan; Peskar, Manca; Marušič, Uroš; Pišot, Saša; Šlosar, Luka; Gasparini, Mladen; Pišot, Rado; Boever, Patrick De; Schmid‐Zalaudek, Karin; Brix, Bianca; Fredriksen, Per Morten; Nkeh-Chungag, Benedicta Ngwechi; Sourij, Harald; Šerý, Omar; Goswami, Nandu

doi:10.1016/j.mvr.2023.104588

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Using the typical retinal vascular changes from our previous studies [ 21 , 22 ] with an error probability (α) of 0.05 and a power (1 − ß) of 0.80, we estimated that the required number of participants was 20. Considering a possible dropout rate of 20%, we recruited forty-two adult participants (20 males, 22 females; age: 24.9 ± 5.9 years; BMI: 21.8 ± 25 kg/m 2 ).…”

Section: Methodsmentioning

confidence: 99%

Sex Variations in Retinal Microcirculation Response to Lower Body Negative Pressure

Saloň,

Vladic,

Schmid-Zalaudek

et al. 2023

Biology

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Introduction: Lower body negative pressure (LBNP) is routinely used to induce central hypovolemia. LBNP leads to a shift in blood to the lower extremities. While the effects of LBNP on physiological responses and large arteries have been widely reported, there is almost no literature regarding how these cephalad fluid shifts affect the microvasculature. The present study evaluated the changes in retinal microcirculation parameters induced by LBNP in both males and females. Methodology: Forty-four participants were recruited for the present study. The retinal measurements were performed at six time points during the LBNP protocol. To prevent the development of cardiovascular collapse (syncope) in the healthy participants, graded LBNP until a maximum of −40 mmHg was applied. A non-mydriatic, hand-held Optomed Aurora retinal camera was used to capture the retinal images. MONA Reva software (version 2.1.1) was used to analyze the central retinal arterial and venous diameter changes during the LBNP application. Repeated measures ANOVAs, including sex as the between-subjects factor and the grade of the LBNP as the within-subjects factor, were performed. Results: No significant changes in retinal microcirculation were observed between the evaluated time points or across the sexes. Conclusions: Graded LBNP application did not lead to changes in the retinal microvasculature across the sexes. The present study is the first in the given area that attempted to capture the changes in retinal microcirculation caused by central hypovolemia during LBNP. However, further research is needed with higher LBNP levels, including those that can induce pre-fainting (presyncope), to fully understand how retinal microcirculation adapts during complete cardiovascular collapse (e.g., during hypovolemic shock) and/or during severe hemorrhage.

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Section: Methodsmentioning

confidence: 99%

Sex Variations in Retinal Microcirculation Response to Lower Body Negative Pressure

Saloň,

Vladic,

Schmid-Zalaudek

et al. 2023

Biology

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“…Solon A. et al [90], Alfadda et al [67], Gameil et al [64] and Mahmoud et al [69] found significantly higher systolic blood pressure in individuals who had experienced SARS-CoV-2 infection. Their hypothesis posits that COVID-19 induced alterations in sympathetic activity, endothelial function or inflammatory response leading to disruptions in blood pressure regulation.…”

Section: Research Supporting Bp Increase As a Complication Of Long Covidmentioning

confidence: 95%

Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19 -Systemic Review

Bielecka,

Sielatycki,

Pietraszko

et al. 2023

Preprint

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Hypertension is one of the most common and significant cardiovascular risk factor. With the emergence of COVID-19, concerns have arisen about its potential to exacerbate cardiovascular morbidity and mortality. Several theories have emerged linking hypertension with COVID-19. However, the relationship between SARS-CoV-2 infection and long-term risk of hypertension remains insufficiently explored. Therefore, our study aimed to investigate the impact of COVID-19 infection on blood pressure and long-term risk of hypertension developing. A comprehensive search was conducted in the PubMed and SCOPUS databases up to 10th August 2023 for relevant papers. The analysis included 35 eligible articles. The majority of the latest studies pointed to increase BP after COVID-19 infection. However, several observations contradicted the influence of SARS-CoV-2 on the hypertension development or suggesting a transient effect. The possible role of the loss of angiotensin-converting enzyme 2, cytokine storm, increased sympathetic activity, and endothelial dysfunction were considered. On the other hand, BP changes following COVID-19 could be a consequence of lifestyle changes, which often accompanied COVID-19 infection. Our findings highlight the urgent need for comprehensive research on the COVID-19 and hypertension link. These insights are crucial for implementing effective prevention and management strategies for individuals with the history of COVID-19 infection.

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“…In the selection of eight eligible studies, various clinical parameters were examined, encompassing blood pressure and other consequences of COVID-19 [58,[60][61][62][63][64][65]. Additionally, as reported in the study by DeLorenzo et al [60], individuals with pre-existing arterial hypertension experienced an elevation in their blood pressure, necessitating adjustments in their treatment regimens due to a loss of disease control.…”

Section: Elevated Blood Pressurementioning

confidence: 99%

“…Researchers, including Xiong [38], Ozcan [42], Akpek [43], Fernandez-Ortega [46], Vyas [47], Gameil [62], and Mahmoud [65], suggested that the described interaction between COVID-19 and ACE-2 may elucidate their respective research findings. A subset of authors has attributed endothelial damage as the underlying cause for the interruption of the reninangiotensin-aldosterone system (RAAS) (Shang [40], Delalic [44], Fernandez-Ortega [46], Vyas [47], Salon [63], Nandadeva [64]). Delic et al [44] sought to identify predictive markers for blood pressure elevation resulting from COVID-19 infections, though none were extracted.…”

Section: The Renin-angiotensin-aldosterone System Inflammatory State ...mentioning

confidence: 99%

“…However, Shang [40] and Salon [63] have proposed that persistent symptoms following a COVID-19 infection may be linked to compromised nervous system function and alterations in sympathetic nervous system activity. In contrast, Nandadewa [64], in a study challenging the notion that SARS-CoV-2 influences blood pressure elevation, underscores that transient increases in blood pressure may result from impaired vasodilation and the potential augmentation of vasodilation alongside heightened sympathetic nervous system activity.…”

Section: Autonomic Nervous Systemmentioning

confidence: 99%

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Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19—A Narrative Review

Bielecka,

Sielatycki,

Pietraszko

et al. 2024

IJMS

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Arterial hypertension is one of the most common and significant cardiovascular risk factors. There are many well-known and identified risk factors for its development. In recent times, there has been growing concern about the potential impact of COVID-19 on the cardiovascular system and its relation to arterial hypertension. Various theories have been developed that suggest a connection between COVID-19 and elevated blood pressure. However, the precise link between SARS-CoV-2 infection and the long-term risk of developing hypertension remains insufficiently explored. Therefore, the primary objective of our study was to investigate the influence of COVID-19 infection on blood pressure elevation and the subsequent risk of developing arterial hypertension over an extended period. To accomplish this, we conducted a thorough search review of relevant papers in the PubMed and SCOPUS databases up to 3 September 2023. Our analysis encompassed a total of 30 eligible articles. Out of the 30 papers we reviewed, 19 of them provided substantial evidence showing a heightened risk of developing arterial hypertension following COVID-19 infection. Eight of the studies showed that blood pressure values increased after the infection, while three of the qualified studies did not report any notable impact of COVID-19 on blood pressure levels. The precise mechanism behind the development of hypertension after COVID-19 remains unclear, but it is suggested that endothelial injury and dysfunction of the renin–angiotensin–aldosterone system may be contributory. Additionally, changes in blood pressure following COVID-19 infection could be linked to lifestyle alterations that often occur alongside the illness. Our findings emphasize the pressing requirement for thorough research into the relationship between COVID-19 and hypertension. These insights are essential for the development of effective prevention and management approaches for individuals who have experienced COVID-19 infection.

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A pilot study: Exploring the influence of COVID-19 on cardiovascular physiology and retinal microcirculation

Cited by 5 publications

References 28 publications

Sex Variations in Retinal Microcirculation Response to Lower Body Negative Pressure

Sex Variations in Retinal Microcirculation Response to Lower Body Negative Pressure

Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19 -Systemic Review

Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19—A Narrative Review

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