Six-month longitudinal tracking of arterial stiffness and blood pressure in young adults following SARS-CoV-2 infection

Szeghy, Rachel E.; Stute, Nina L.; Province, Valesha M.; Augenreich, Marc; Stickford, Jonathon L.; Stickford, Abigail S.L.; Ratchford, Stephen M.

doi:10.1152/japplphysiol.00793.2021

Cited by 26 publications

(19 citation statements)

References 99 publications

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“…Likewise, arterial stiffness was also shown to be inversely related to time since diagnosis. These findings are in agreement with the findings of a recent follow up study by Szeghy et al ( 29 ), which showed improvement in carotid-femoral PWV over the first 6 mo from diagnosis in young otherwise healthy adults who had COVID-19. Although no significant relationship with time since diagnosis was found for central BP in the current study, Szeghy et al ( 29 ) reported an improvement in central systolic BP and mean BP at 6 mo compared with 1 mo after diagnosis.…”

Section: Discussionsupporting

confidence: 93%

“…These findings are in agreement with the findings of a recent follow up study by Szeghy et al ( 29 ), which showed improvement in carotid-femoral PWV over the first 6 mo from diagnosis in young otherwise healthy adults who had COVID-19. Although no significant relationship with time since diagnosis was found for central BP in the current study, Szeghy et al ( 29 ) reported an improvement in central systolic BP and mean BP at 6 mo compared with 1 mo after diagnosis. Collectively, these findings provide evidence for a potential transient impact of COVID-19 on indices of cardiovascular health in young adults.…”

Section: Discussionsupporting

confidence: 93%

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Impact of COVID-19 on ambulatory blood pressure in young adults: a cross-sectional analysis investigating time since diagnosis

Nandadeva

Skow

Grotle

et al. 2022

Journal of Applied Physiology

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Previous studies have reported detrimental effects of COVID-19 on the peripheral vasculature. However, reports on blood pressure (BP) are inconsistent and measurements made only in the laboratory setting. To date, no studies have measured ambulatory BP. Additionally, in previous studies, time since COVID-19 diagnosis among participants varied across a wide range, potentially contributing to the inconsistent BP results. Thus, we aimed to perform a comprehensive assessment of BP and BP variability using ambulatory and laboratory (brachial and central) measurements in young adults who had COVID-19. We hypothesized that ambulatory BP would be elevated post-COVID-19, and that measures of BP would be inversely related with time since diagnosis. Twenty-eight young adults who had COVID-19 (11 ± 6 [range 3 to 22] weeks since diagnosis) and 10 controls were studied. Ambulatory daytime, nighttime, and 24-hr systolic BP, diastolic BP, and mean BP were not different between control and COVID groups (e.g., daytime systolic BP: control,122 ± 12 mmHg; COVID,122 ± 10 mmHg; P = 0.787). Similar results were observed for laboratory BPs (all P > 0.05). However, ambulatory daytime, nighttime, and 24-hr BPs as well as laboratory brachial BPs were inversely correlated with time since COVID-19 diagnosis (e.g., daytime systolic BP: r = -0.444; P = 0.044, nighttime systolic BP: r = -0.518; P = 0.016). Ambulatory and laboratory measured BP variability were not different between groups nor correlated with time since diagnosis. Collectively, these data suggest that adverse effects of COVID-19 on BP in young adults are minimal and likely transient.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Impact of COVID-19 on ambulatory blood pressure in young adults: a cross-sectional analysis investigating time since diagnosis

Nandadeva

Skow

Grotle

et al. 2022

Journal of Applied Physiology

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“…This is similar to the data from middle-aged adults that showed cardiac BRS was lower <3 mo compared with >3 mo from diagnosis ( 20 ). Together, these findings align with previous data indicating a time-course improvement in blood pressure and arterial stiffness in young adults ( 21 , 22 ) and suggest that similarly, any potential autonomic changes following COVID-19 are transient in young, otherwise healthy adults.…”

Section: Discussionsupporting

confidence: 90%

Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis

Skow

Garza

Nandadeva

et al. 2022

American Journal of Physiology-Heart and Circulatory Physiology

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Emerging evidence suggests COVID-19 may affect cardiac autonomic function; however, the limited findings in young adults with COVID-19 have been equivocal. Notably, symptomology and time since diagnosis appear to influence vascular health following COVID-19, but this has not been explored in the context of cardiac autonomic regulation. Therefore, we hypothesized that young adults who had persistent symptoms following COVID-19 would have lower heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) compared to those who had COVID-19 but were asymptomatic at testing and controls who never had COVID-19. Further, we hypothesized that there would be relationships between cardiac autonomic function measures and time since diagnosis. We studied 27 adults who had COVID-19 and were either asymptomatic (ASYM; n=15 (6 female); 21±4 years; 8.4±4.0 weeks from diagnosis) or symptomatic (SYM; n=12 (9 female); 24±3 years; 12.3±6.2 weeks from diagnosis) at testing, and 20 adults who reported never having COVID-19 (24±4 years, 11 female). Heart rate and beat-to-beat blood pressure were continuously recorded during 5-minutes of rest to assess HRV and cardiac BRS. HRV (root mean square of successive differences between normal heartbeats [RMSSD]; control: 73±50ms; ASYM: 71±47ms; SYM: 84±45ms; p=0.774) and cardiac BRS (overall gain; control: 22.3±10.1ms/mmHg; ASYM: 22.7±12.2ms/mmHg; SYM: 24.3±10.8ms/mmHg; p=0.871) were not different between groups. However, we found correlations with time since diagnosis for HRV (e.g., RMSSD: r=0.460, p=0.016) and cardiac BRS (overall gain, r=0.470, p=0.014). These data suggest a transient impact of COVID-19 on cardiac autonomic function that appears mild and unrelated to persistent symptoms in young adults.

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“…Thus, we may have expected to observe concomitant reductions in sympathetic activity and BP if the current study had included older adults recovering from SARS‐CoV‐2. The reductions in resting BP in the present study could be due to improvements in endothelial function (Ratchford et al, 2021) and/or decreased arterial stiffness (Szeghy et al, 2021), as assessed by carotid‐femoral pulse wave velocity (Szeghy et al, 2022) over 6 months recovery in this cohort. No changes in estimated cardiac output were observed over time in this cohort, further supporting the potential role of changes in endothelial function and/or arterial stiffness in observed reductions in BP in the months following SARS‐CoV‐2 infection.…”

Section: Discussionmentioning

confidence: 62%

Longitudinal observations of sympathetic neural activity and hemodynamics during 6 months recovery from SARS‐CoV ‐2 infection

Stute

Szeghy

Stickford

et al. 2022

Physiological Reports

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Cross‐sectional data indicate that acute SARS‐CoV‐2 infection increases resting muscle sympathetic nerve activity (MSNA) and alters hemodynamic responses to orthostasis in young adults. However, the longitudinal impact of contracting SARS‐CoV‐2 on autonomic function remains unclear. The aim of this study was to longitudinally track MSNA, sympathetic transduction to blood pressure (BP), and hemodynamics over 6 months following SARS‐CoV‐2 infection. Young adults positive with SARS‐CoV‐2 reported to the laboratory three times over 6 months (V1:41 ± 17, V2:108 ± 21, V3:173 ± 16 days post‐infection). MSNA, systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured at rest, during a cold pressor test (CPT), and at 30° head‐up tilt (HUT). Basal SBP (p = 0.019) and DBP (p < 0.001) decreased throughout the 6 months, whereas basal MSNA and HR were not different. Basal sympathetic transduction to BP and estimates of baroreflex sensitivity did not change over time. SBP and DBP were lower during CPT (SBP: p = 0.016, DBP: p = 0.007) and HUT at V3 compared with V1 (SBP: p = 0.041, DBP: p = 0.017), with largely no changes in MSNA. There was a trend toward a visit‐by‐time interaction for burst incidence (p = 0.055) during HUT, wherein at baseline immediately prior to tilting, burst incidence was lower at V3 compared with V1 (p = 0.014), but there were no differences between visits in the 30 HUT position. These results support impairments to cardiovascular health, and potentially autonomic function, which may improve over time. However, the improvements in BP over 6 months recovery from mild SARS‐CoV‐2 infection are likely not a direct result of changes in sympathetic activity.

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Six-month longitudinal tracking of arterial stiffness and blood pressure in young adults following SARS-CoV-2 infection

Cited by 26 publications

References 99 publications

Impact of COVID-19 on ambulatory blood pressure in young adults: a cross-sectional analysis investigating time since diagnosis

Impact of COVID-19 on ambulatory blood pressure in young adults: a cross-sectional analysis investigating time since diagnosis

Impact of COVID-19 on cardiac autonomic function in healthy young adults: potential role of symptomatology and time since diagnosis

Longitudinal observations of sympathetic neural activity and hemodynamics during 6 months recovery from SARS‐CoV ‐2 infection

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