Sustained inflammation, coagulation activation and elevated endothelin-1 levels without macrovascular dysfunction at...

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Immunology

Background:

• COVID-19 can cause endothelial damage and thrombosis, potentially impacting long-term cardiovascular health.
• Limited data exists on the persistent effects of COVID-19 on vascular function beyond the acute phase.

Purpose of the Study:

• To investigate endothelial dysfunction, coagulation, and inflammation three months after COVID-19 infection.
• To assess long-term cardiovascular implications in patients recovering from COVID-19.

Main Methods:

• A cohort study of 203 COVID-19 patients and 312 historical controls.
• Macrovascular dysfunction assessed via carotid artery diameter response to cold stimulus.
• Plasma endothelin-1, coagulation enzyme:inhibitor complexes, and inflammatory cytokines were measured.

Main Results:

• No significant difference in macrovascular dysfunction prevalence between COVID-19 survivors and controls.
• Significantly elevated endothelin-1 levels persisted three months post-COVID-19.
• Elevated markers of coagulation (thrombin:antithrombin, FVIIa:AT, Von Willebrand Factor) and inflammation (IL-18, IL-6, IL-1ra) were observed.

Conclusions:

• While macrovascular function may recover, sustained endothelial cell involvement, coagulation activity, and inflammation are evident three months post-COVID-19.
• These findings underscore the need for further research into SARS-CoV-2-related vascular inflammation and thrombosis.
• Longer follow-up studies are crucial for understanding the long-term vascular consequences of COVID-19.