Evaluation of Endothelial Dysfunction and Inflammatory Vasculopathy After SARS-CoV-2 Infection-A Cross-Sectional...

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Pathology

Background:

• Emerging evidence links COVID-19 to vascular endothelium damage.
• Mechanisms behind COVID-19-induced endothelial dysfunction and vasculopathy remain unclear.

Purpose of the Study:

• To assess COVID-19's contribution to persistent vascular injury.
• To identify factors associated with COVID-19-related endothelial dysfunction and vasculopathy.

Main Methods:

• Cross-sectional study comparing post-COVID-19 patients, atherosclerotic cardiovascular disease (ASCVD) patients, and healthy controls.
• Evaluated flow-mediated dilation (FMD), nitroglycerine-related dilation (NMD), pulse-wave velocity (PWV), augmentation index, intima-media thickness (IMT), arginine/kynurenine metabolism, homocysteine, von Willebrand factor (vWF), endothelial microparticles (EMP), antibodies, inflammatory markers, and nailfold capillary morphology.

Main Results:

• Post-COVID-19 patients exhibited elevated PWV, augmentation index, IMT, dimethylarginines, vWF, homocysteine, EMPs, C-reactive protein, erythrocyte sedimentation rate, interleukin-6, and beta-2-glycoprotein antibodies.
• Lower levels of homoarginine and tryptophan were noted in post-COVID-19 patients.
• Significant alterations in capillary morphology and a higher microangiopathy score were observed in post-COVID-19 patients.
• Endothelial dysfunction and inflammation markers were comparable between post-COVID-19 and ASCVD patients.

Conclusions:

• COVID-19 impacts arterial stiffness, capillary structure, EMPs, and metabolism of arginine, kynurenine, and homocysteine.
• These effects contribute to endothelial dysfunction and inflammatory vasculopathy post-COVID-19.
• The vascular damage observed in post-COVID-19 patients resembles that seen in ASCVD.