Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
| Autor: | Loes H. Willems, Lotte M. C. Jacobs, Laszlo A. Groh, Hugo ten Cate, Henri M. H. Spronk, Boden Wilson-Storey, Gerjon Hannink, Sander M. J. van Kuijk, Chahinda Ghossein-Doha, Magdi Nagy, Dick H. J. Thijssen, André S. van Petersen, Michiel C. Warlé |
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| Přispěvatelé: | Interne Geneeskunde, MUMC+: MA Alg Interne Geneeskunde (9), RS: Carim - B04 Clinical thrombosis and Haemostasis, Biochemie, RS: CAPHRI - R2 - Creating Value-Based Health Care, Epidemiologie, MUMC+: KIO Kemta (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Obstetrie & Gynaecologie, MUMC+: MA Med Staf Artsass Cardiologie (9) |
| Rok vydání: | 2023 |
| Předmět: |
RISK
Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] carotid artery reactivity (CAR) All institutes and research themes of the Radboud University Medical Center CARDIOVASCULAR-DISEASE inflammatory cytokines Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] COVID-19 macrovascular dysfunction Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] General Medicine DYSFUNCTION |
| Zdroj: | Journal of Clinical Medicine, 12, 4 Journal of Clinical Medicine, 12 Journal of Clinical Medicine Volume 12 Issue 4 Pages: 1413 Journal of Clinical Medicine, 12(4):1413. Multidisciplinary Digital Publishing Institute (MDPI) |
| ISSN: | 2077-0383 |
| Popis: | 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: | OpenAIRE |
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