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

Philipp Jud1, Paul Gressenberger1, Viktoria Muster1

  • 1Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Frontiers in Cardiovascular Medicine
|November 1, 2021
PubMed

Insights

COVID-19 can cause lasting vascular injury, affecting arterial stiffness and capillary structure. These changes contribute to endothelial dysfunction and inflammation, similar to atherosclerotic cardiovascular disease.

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.

Keywords:
COVID-19capillary changesendothelial dysfunctioninflammationvasculopathy

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