Covid-19 Accelerates Vascular Aging In Women

The world’s largest study of COVID-19 survivors shows nan microorganism accelerates vascular aging, particularly successful women, while vaccination and betterment whitethorn thief lessen nan semipermanent damage.

Study: Accelerated vascular ageing aft COVID-19 infection: nan CARTESIAN study. Image credit: Anatoliy Cherkas/Shutterstock.com

A study published successful European Heart Journal revealed that coronavirus illness 2019 (COVID-19) tin summation arterial stiffness and accelerate vascular aging, particularly successful women.

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), nan causative pathogen of nan COVID-19 pandemic, is persistently associated pinch important morbidity and mortality worldwide, moreover aft much than 4 years of its emergence. Besides acute illness, a ample proportionality of COVID-19 survivors are still experiencing semipermanent wellness complications, which is clinically defined arsenic long-COVID.

Cardiovascular events are among nan astir commonly reported long-COVID consequences, which person been observed for up to 12 months aft infection. There is simply a gradient of consequence according to nan severity of acute COVID-19 infection. This is not surprising, arsenic SARS-CoV-2 is known to straight aliases indirectly impact nan vascular system.

Identifying COVID-19 survivors who are astatine higher consequence of processing semipermanent cardiovascular complications is, therefore, basal to protect them done pharmacological aliases non-pharmacological measures.

Measurement of arterial stiffness is an effective method to measure vascular aging, a beardown parameter for accurately classifying at-risk individuals. In opposition to chronological aging, vascular aging reflects individual variability successful vascular illness onset and mortality.

The CARTESIAN study is nan first world multi-center study to research whether COVID-19 survivors acquisition accelerated vascular ageing proportional to nan severity of nan infection.

The CARTESIAN study

The study recruited 2390 individuals from 38 centers successful 18 countries. Analyses were performed connected ~2,094 participants pinch vascular measurements available. Based connected their COVID-19 status, nan participants were categorized into 4 groups.

The first group included participants pinch SARS-CoV-2-negative results (control group); nan 2nd group included non-hospitalized participants pinch confirmed SARS-CoV-2 infection; nan 3rd group included hospitalized participants pinch confirmed infection; and nan 4th group included participants pinch confirmed infection who required intensive attraction portion (ICU) admission. All COVID-19 patients were assessed 6 ± 3 months aft SARS-CoV-2 infection.

All participants were evaluated for carotid-femoral beat activity velocity, an established biomarker for ample artery stiffness and vascular aging.

Key findings

The study reported that each participants pinch confirmed SARS-CoV-2 infection person a importantly higher ample artery stiffness than SARS-CoV-2-negative participants. The gender-specific study revealed that women pinch confirmed infection person importantly higher ample artery stiffness than those without infection, irrespective of COVID-19 severity. However, nary important quality was observed betwixt men pinch and without confirmed infection.

Among infected women, nan summation successful arterial stiffness compared pinch controls was ≈ +0.55-0.60 m/s successful non-hospitalized and hospitalized cases, and ≈ +1.09 m/s successful those admitted to nan ICU. Furthermore, women pinch persistent COVID-19 symptoms had importantly higher arterial stiffness than afloat recovered women, sloppy of illness severity and cardiovascular confounders.

The study included different information of vascular measurements taken from nan participants astatine nan 2nd follow-up visit, astir 12 months from nan first follow-up visit. These measurements indicated a unchangeable aliases improved ample artery stiffness complete clip successful participants pinch confirmed infection. In contrast, non-infected participants exhibited accrued ample artery stiffness, which whitethorn beryllium owed to chronological aging.

Study significance

The study reveals that COVID-19 tin importantly accelerate vascular aging sloppy of illness severity, peculiarly successful women. Among various cardiovascular consequence factors, nan study finds that nan relation betwixt COVID-19 and vascular aging is only partially mediated by elevated humor pressure. The 12-month follow-up findings bespeak that nan accrued arterial stiffness partially attenuates successful nan agelong term.

The study identifies factors positively aliases negatively associated pinch accelerated vascular aging successful women pinch COVID-19. These factors are vaccination, which was associated pinch little arterial stiffness successful women astatine six months and remained associated pinch little stiffness astatine ~ 12 months, particularly successful hospitalized groups, and persistent COVID-19 symptoms, which summation nan consequence of arterial stiffness. However, causality cannot beryllium inferred.

Evidence regarding COVID-19-related vascular harm suggests that SARS-CoV-2 tin change nan functionality of vascular endothelial cells, that viral RNA tin persist successful these cells, and subsequently induce chronic inflammatory responses, starring to vascular damage.

An accrued vascular inflammation has been observed successful nan early post-infection shape successful patients pinch terrible COVID-19, which whitethorn trigger fibrotic changes and initiate nan long-lasting process of arterial stiffening.

Some small-scale studies person antecedently reported endothelial dysfunction and arterial stiffness up to six months aft an acute COVID-19 infection. However, nan existent study is nan first large-scale study to accurately show COVID-19-induced vascular ageing and its narration pinch illness severity, independent of cardiovascular consequence facet burden.  

The accrued susceptibility to vascular aging observed successful women could beryllium owed to nan differences successful immune strategy usability betwixt females and males. Females grounds much accelerated and robust innate and adaptive immune responses than males, which mightiness accelerate their betterment from first infection and protect them against terrible disease. However, nan aforesaid quality tin summation their susceptibility to prolonged autoimmune-related diseases.

The study reports that Asians and Latin Americans person little arterial stiffness than Caucasians successful nan COVID-19 antagonistic group, but not successful nan COVID-19 affirmative group. This uncovering suggests that nan taste benefits of cardiovascular fittingness tin beryllium offset by SARS-CoV-2 infection.

The study links COVID-19 pinch mid-term and semipermanent accelerated vascular aging, particularly successful women. Further studies are needed to find whether these preclinical changes are associated pinch objective cardiovascular events, and whether newer SARS-CoV-2 variants aliases SARS-CoV-2 reinfections are associated pinch accelerated vascular ageing to nan aforesaid extent.

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