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Atherosclerosis Associated With COVID-19: Acute, Tends to Severely Involve Peripheral Arteries, and May be Reversible

Eman O Mahmoud1, Yumn A Elsabagh1, Nagwa Abd El Ghaffar2

  • 1Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt.

Angiology
|August 23, 2023
PubMed

Insights

COVID-19 patients showed signs of subclinical atherosclerosis, with increased arterial stiffness and inflammation markers. These changes in peripheral arteries may be reversible, suggesting potential for early intervention.

Area of Science:

  • Vascular Medicine
  • Infectious Diseases
  • Cardiology

Background:

  • Arterial stiffness is a known complication of coronavirus disease 2019 (COVID-19).
  • The direct impact of COVID-19 on atherosclerosis and its relationship with disease severity markers requires further investigation.

Purpose of the Study:

  • To investigate atherosclerosis in COVID-19 patients using duplex ultrasound.
  • To assess the relationship between atherosclerosis markers, comorbidities, clinical severity, and inflammatory markers (interleukin-6 and -17).

Main Methods:

  • Duplex ultrasound measurements of carotid intima-media thickness (cIMT), peripheral artery diameter, and peak systolic velocities (PSV).
  • Ankle-brachial index (ABI) measurements.
  • Serum levels of interleukin (IL)-6 and IL-17 were measured in 44 COVID-19 patients and 44 healthy controls.

Main Results:

  • COVID-19 patients exhibited higher IL-6, IL-17, PSV, and cIMT, with lower arterial diameter compared to controls (P ≤ .01).
  • Clinical severity correlated positively with age, comorbidities, ferritin, IL-6, IL-17, cIMT, and PSV, and negatively with diameter and ABI (P ≤ .04).
  • IL-6 inhibitor treatment (tocilizumab) was associated with reduced PSV and increased arterial diameter (P ≤ .01).

Conclusions:

  • COVID-19 is associated with subclinical, potentially reversible atherosclerosis, particularly affecting peripheral arteries.
  • Inflammatory markers like IL-17 and factors such as age and comorbidities significantly influence arterial stiffness and atherosclerosis in COVID-19 patients.

Keywords:
atherosclerosiscorona virus disease 2019duplex ultrasoundinterleukin 17interleukin 6

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