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Observational Study
. 2021 Dec 15:345:153-155.
doi: 10.1016/j.ijcard.2021.10.140. Epub 2021 Oct 24.

In-vivo evidence of systemic endothelial vascular dysfunction in COVID-19

Hernan Mejia-Renteria  1 , Alejandro Travieso  2 , Adam Sagir  3 , Eduardo Martínez-Gómez  2 , Angela Carrascosa-Granada  2 , Takumi Toya  4 , Iván J Núñez-Gil  2 , Vicente Estrada  2 , Amir Lerman  4 , Javier Escaned  2
Affiliations
Observational Study

In-vivo evidence of systemic endothelial vascular dysfunction in COVID-19

Hernan Mejia-Renteria et al. Int J Cardiol. .

Abstract

Background: Endothelial dysfunction is one of the underlying mechanisms to vascular and cardiac complications in patients with COVID-19. We sought to investigate the systemic vascular endothelial function and its temporal changes in COVID-19 patients from a non-invasive approach with reactive hyperemia peripheral arterial tonometry (PAT).

Methods: This is a prospective, observational, case-control and blinded study. The population was comprised by 3 groups: patients investigated during acute COVID-19 (group 1), patients investigated during past COVID-19 (group 2), and controls 1:1 matched to COVID-19 patients by demographics and cardiovascular risk factors (group 3). The natural logarithmic scaled reactive hyperemia index (LnRHI), a measure of endothelium-mediated dilation of peripheral arteries, was obtained in all the participants and compared between study groups.

Results: 144 participants were enrolled (72 COVID-19 patients and 72 matched controls). Median time from COVID-19 symptoms to PAT assessment was 9.5 and 101.5 days in groups 1 and 2, respectively. LnRHI was significantly lower in group 2 compared to both group 1 and controls (0.53 ± 0.23 group 2 vs. 0.72 ± 0.26 group 1, p = 0.0043; and 0.79 ± 0.23 in group 3, p < 0.0001). In addition, within group 1, it was observed a markedly decrease in LnRHI from acute COVID-19 to post infection stage (0.73 ± 0.23 vs. 0.42 ± 0.26, p = 0.0042).

Conclusions: This study suggests a deleterious effect of SARS-CoV-2 infection on systemic vascular endothelial function. These findings open new venues to investigate the clinical implication and prognostic role of vascular endothelial dysfunction in COVID-19 patients and post-COVID syndrome using non-invasive techniques.

Keywords: COVID-19; SARS-CoV-2; Systemic vascular endothelial function.

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Conflict of interest statement

The authors state that they do not have any conflict of interest related with the submitted study.

Figures

Fig. 1
Fig. 1
Comparison of endothelial vasodilator function between study groups as determined by PAT. Legend: A. Box-Whisker plots comparing LnRHI values between study groups. Patients with PAT assessment performed during post-infection stage (group 2) had a significantly reduced vasodilator function compared to the other groups. B. Pair PAT data with dot-line diagram and Box-Whisker plots showing a markedly decreased in the endothelial vasodilator function from acute to post-infection stage within same patients (group 1 only).
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References

    1. Bikdeli B., Madhavan M.V., Jimenez D., et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2020;75:2950–2973. - PMC - PubMed
    1. Hamming I., Timens W., Bulthuis M.L.C., Lely A.T., Navis G.J., van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J. Pathol. 2004;203:631–637. - PMC - PubMed
    1. Libby P., Lüscher T. COVID-19 is, in the end, an endothelial disease. Eur. Heart J. 2020;41:3038–3044. - PMC - PubMed
    1. Varga Z., Flammer A.J., Steiger P., et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet Lond. Engl. 2020;395:1417–1418. - PMC - PubMed
    1. Rubinshtein R., Kuvin J.T., Soffler M., et al. Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events. Eur. Heart J. 2010;31:1142–1148. - PubMed

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