Long-Term Adverse Effects of Mild COVID-19 Disease on Arterial Stiffness, and Systemic and Central Hemodynamics: A Pre-Post Study

Abstract

COVID-19-associated vascular disease complications are primarily associated with endothelial dysfunction; however, the consequences of disease on vascular structure and function, particularly in the long term (> 7 weeks post-infection), remain unexplored. Individual pre- and post-infection changes in arterial stiffness as well as central and systemic hemodynamic parameters were measured in patients diagnosed with mild COVID-19. As part of in-laboratory observational studies, baseline measurements were taken up to two years before, whereas the post-infection measurements were made 2–3 months after the onset of COVID-19. We used the same measurement protocol throughout the study as well as linear and mixed-effects regression models to analyze the data. Patients (N = 32) were predominantly healthy and young (mean age ± SD: 36.6 ± 12.6). We found that various parameters of arterial stiffness and central hemodynamics—cfPWV, AIx@HR75, and cDBP as well as DBP and MAP—responded to a mild COVID-19 disease. The magnitude of these responses was dependent on the time since the onset of COVID-19 as well as age (pregression_models ≤ 0.013). In fact, mixed-effects models predicted a clinically significant progression of vascular impairment within the period of 2–3 months following infection (change in cfPWV by +1.4 m/s, +15% in AIx@HR75, approximately +8 mmHg in DBP, cDBP, and MAP). The results point toward the existence of a widespread and long-lasting pathological process in the vasculature following mild COVID-19 disease, with heterogeneous individual responses, some of which may be triggered by an autoimmune response to COVID-19.

Long-term effects of COVID-19 on endothelial function, arterial stiffness, and blood pressure in college students: a pre-post-controlled study

“…Another study demonstrated that at least 6 months after infection, COVID-19 survivors without other comorbidities associated with endothelial damage only showed mild evidence of endothelial dysfunction (41) . However, there were also studies indicating that the vascular damage became more severe with the progression of infection time (42) . Further investigation is warranted to explore the long-term effects of cardiovascular damage following COVID-19 infection.…”

Population Trends of New Prescriptions for Antihyperglycemics and Antihypertensives Between 2014 and 2022

“…The increased risk of new diabetes or hypertension among patients infected with SARS‐CoV‐2 compared with patients without infection, historical controls, or patients with a non–SARS‐CoV‐2 respiratory infection has been previously reported. 1 , 3 , 22 , 23 , 24 The higher risk of diabetes was seen even in patients with low preinfection risk of diabetes and may extend beyond the acute infection period, especially among those who develop symptoms of long COVID. 1 , 25 Given widespread undocumented COVID infection and long COVID in the population, it is relevant to quantify any increases in the population‐based rate of incident users of medications for diabetes or hypertension.…”

Increased risk of arrhythmias, heart failure, and thrombosis in SARS-CoV-2 positive individuals persists at one year post-infection

“…This elevated risk of bypass/revascularization is probably a consequence of the higher incidence of ischemic heart disease in SARS-CoV-2 positive individuals. Other authors suggest that the increased occurrence of peripheral artery disease could be due to worsening arterial stiffness following SARS-CoV-2 infection [25] , [26] .…”