Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study.

Autor: Willems LH; Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands., Jacobs LMC; Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands., Groh LA; Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands., Ten Cate H; Departments of Internal Medicine and Biochemistry, MUMC and CARIM School for Cardiovascular Diseases, 6229 ER Maastricht, The Netherlands.; Center for Thrombosis and Haemostasis, Gutenberg University Medical Center, 55131 Mainz, Germany., Spronk HMH; Departments of Internal Medicine and Biochemistry, MUMC and CARIM School for Cardiovascular Diseases, 6229 ER Maastricht, The Netherlands., Wilson-Storey B; Department of Surgery, Bernhoven Hospital, 5406 PT Uden, The Netherlands., Hannink G; Department of Medical Imaging, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands., van Kuijk SMJ; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands., Ghossein-Doha C; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), 6229 ER Maastricht, The Netherlands., Nagy M; Departments of Internal Medicine and Biochemistry, MUMC and CARIM School for Cardiovascular Diseases, 6229 ER Maastricht, The Netherlands., Thijssen DHJ; Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5UX, UK., van Petersen AS; Department of Surgery, Bernhoven Hospital, 5406 PT Uden, The Netherlands., Warlé MC; Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Feb 10; Vol. 12 (4). Date of Electronic Publication: 2023 Feb 10.
DOI: 10.3390/jcm12041413
Abstrakt: Introduction: Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown sustained microvascular dysfunction, systemic inflammation, and coagulation activation at 3 months after acute COVID-19. The long-term effects of COVID-19 on vascular function remain unknown.
Materials and Methods: This cohort study involved 167 patients who participated in the COVAS trial. At 3 months and 18 months after acute COVID-19, macrovascular dysfunction was evaluated by measuring the carotid artery diameter in response to cold pressor testing. Additionally, plasma endothelin-1, von Willebrand factor, Interleukin(IL)-1ra, IL-6, IL-18, and coagulation factor complexes were measured using ELISA techniques.
Results: The prevalence of macrovascular dysfunction did not differ between 3 months (14.5%) and 18 months (11.7%) after COVID-19 infection ( p = 0.585). However, there was a significant decrease in absolute carotid artery diameter change, 3.5% ± 4.7 vs. 2.7% ± 2.5, p -0.001, respectively. Additionally, levels of vWF:Ag were persistently high in 80% of COVID-19 survivors, reflecting endothelial cell damage and possibly attenuated endothelial function. Furthermore, while levels of the inflammatory cytokines interleukin(IL)-1RA and IL-18 were normalized and evidence of contact pathway activation was no longer present, the concentrations of IL-6 and thrombin:antithrombin complexes were further increased at 18 months versus 3 months (2.5 pg/mL ± 2.6 vs. 4.0 pg/mL ± 4.6, p = 0.006 and 4.9 μg/L ± 4.4 vs. 18.2 μg/L ± 11.4, p < 0.001, respectively).
Discussion: This study shows that 18 months after COVID-19 infection, the incidence of macrovascular dysfunction as defined by a constrictive response during carotid artery reactivity testing is not increased. Nonetheless, plasma biomarkers indicate sustained endothelial cell activation (vWF), systemic inflammation (IL-6), and extrinsic/common pathway coagulation activation (FVII:AT, TAT) 18 months after COVID-19 infection.
Databáze: MEDLINE
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