Long COVID 19 Syndrome: Is It Related to Microcirculation and Endothelial Dysfunction? Insights From TUN-EndCOV Study
Salma Charfeddine1,2, Hassen Ibn Hadj Amor3, Jihen Jdidi2,4
1Cardiology Department, Hedi Chaker University Hospital Sfax, Sfax, Tunisia.
Insights
Long COVID-19 symptoms are linked to persistent endothelial dysfunction, a vascular issue. This study used finger thermal monitoring to identify endothelial dysfunction in long COVID patients, aiding better patient care.
Area of Science:
- Cardiovascular Research
- Infectious Disease Epidemiology
- Medical Technology Assessment
Background:
- COVID-19 is a multisystem disease impacting vascular endothelium.
- Persistent endothelial dysfunction may cause long COVID-19 sequelae.
- Understanding this link is crucial for managing long COVID.
Purpose of the Study:
- To evaluate endothelial quality index (EQI) in long COVID-19 patients.
- To determine the association between EQI and long COVID-19 symptoms.
- To identify risk factors for long COVID-19 syndrome.
Main Methods:
- Cross-sectional, multicenter observational study with prospective recruitment.
- Utilized finger thermal monitoring with E4 diagnosis Polymath to assess EQI.
- Included 798 patients, with 618 experiencing long COVID-19 symptoms.
Main Results:
- Mean EQI was 2.02 ± 0.99; 49.7% of patients had impaired EQI (<2).
- Fatigue, chest pain, and neuro-cognitive difficulties significantly associated with endothelial dysfunction.
- Endothelial dysfunction, female gender, and severe acute COVID-19 were independent risk factors for long COVID-19.
Conclusions:
- Long COVID-19 symptoms, particularly non-respiratory, stem from persistent endothelial dysfunction.
- Impaired EQI is a key indicator of long COVID-19 syndrome.
- Findings support improved patient care strategies for long COVID-19.
Abstract:
The COVID-19 disease is a multisystem disease due in part to the vascular endothelium injury. Lasting effects and long-term sequelae could persist after the infection and may be due to persistent endothelial dysfunction. Our study focused on the evaluation of endothelial quality index (EQI) by finger thermal monitoring with E4 diagnosis Polymath in a large cohort of long COVID-19 patients to determine whether long-covid 19 symptoms are associated with endothelial dysfunction. This is a cross-sectional multicenter observational study with prospective recruitment of patients. A total of 798 patients were included in this study. A total of 618 patients (77.4%) had long COVID-19 symptoms. The mean EQI was 2.02 ± 0.99 IC95% [1.95-2.08]. A total of 397 (49.7%) patients had impaired EQI. Fatigue, chest pain, and neuro-cognitive difficulties were significantly associated with endothelium dysfunction with an EQI <2 after adjustment for age, sex, diabetes, hypertension, dyslipidemia, coronary heart disease, and the severity of acute COVID-19 infection. In multivariate analysis, endothelial dysfunction (EQI <2), female gender, and severe clinical status at acute COVID-19 infection with a need for oxygen supplementation were independent risk factors of long COVID-19 syndrome. Long COVID-19 symptoms, specifically non-respiratory symptoms, are due to persistent endothelial dysfunction. These findings allow for better care of patients with long COVID-19 symptoms.
