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Monitoring Changes in Human Umbilical Vein Endothelial Cells upon Viral Infection Using Impedance-Based Real-Time Cell Analysis
Published on: May 5, 2023
Endothelial dysfunction and cardiovascular risk in post-COVID-19 patients after 6- and 12-months SARS-CoV-2 infection
Paula Poyatos1,2, Neus Luque1, Gladis Sabater1,2
1Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain.
Insights
Post-COVID-19 patients show persistent vascular damage and altered endothelial-colony forming cells (ECFCs) up to 12 months. Lower ECFCs correlate with higher inflammation, suggesting a protective role and need for follow-up.
Area of Science:
- Cardiovascular Research
- Infectious Disease Immunology
- Vascular Biology
Background:
- SARS-CoV-2 infection induces endothelial damage, a key factor in cardiovascular complications.
- Endothelial-colony forming cells (ECFCs) are vascular damage biomarkers, but their role in COVID-19 sequelae is unclear.
Purpose of the Study:
- To investigate long-term alterations in ECFCs and angiogenic biomarkers post-COVID-19.
- To determine if these changes correlate with long-COVID syndrome and cardiovascular risk markers.
Main Methods:
- Recruited 72 post-COVID-19 patients and 31 healthy controls, matched for demographics and comorbidities.
- Quantified ECFCs from peripheral blood and measured angiogenic biomarkers, troponin, NT-proBNP, and ferritin levels.
Main Results:
- Elevated ECFC production persisted 6 and 12 months post-infection (82.8% vs. 48.4% in controls).
- Significant downregulation of angiogenesis proteins and elevated cardiovascular risk markers (troponin, NT-proBNP, ferritin) were observed up to 12 months.
- Lower ECFC counts correlated with higher ferritin levels, suggesting a protective role for ECFCs.
Conclusions:
- Vascular sequelae persist for up to 12 months after SARS-CoV-2 infection.
- ECFCs may play a protective role against inflammation and cardiovascular risk.
- Highlights the need for preventive strategies and long-term patient monitoring.
Introduction:
SARS-CoV-2 infection causes severe endothelial damage, an essential step for cardiovascular complications. Endothelial-colony forming cells (ECFCs) act as a biomarker of vascular damage but their role in SARS-CoV-2 remain unclear. The aim of this study was to assess whether the number of ECFCs and angiogenic biomarkers remained altered after 6 and 12-months post-infection and whether this imbalance correlated with the presence of long-COVID syndrome and other biological parameters measured.
Methods:
Seventy-two patients were recruited at different time-points after overcoming COVID-19 and thirty-one healthy controls. All subjects were matched for age, gender, BMI, and comorbidities. ECFCs were obtained from peripheral blood and cultured with specific conditions.
Results:
The results confirm the presence of a long-term sequela in post-COVID-19 patients, with an abnormal increase in ECFC production compared to controls (82.8% vs. 48.4%, P < 0.01) that is maintained up to 6-months (87.0% vs. 48.4%, P < 0.01) and 12-months post-infection (85.0% vs. 48.4%, P < 0.01). Interestingly, post-COVID-19 patients showed a significant downregulation of angiogenesis-related proteins compared to controls indicating a clear endothelial injury. Troponin, NT-proBNP and ferritin levels, markers of cardiovascular risk and inflammation, remained elevated up to 12-months post-infection. Patients with lower numbers of ECFC exhibited higher levels of inflammatory markers, such as ferritin, suggesting that ECFCs may play a protective role. Additionally, long-COVID syndrome was associated with higher ferritin levels and with female gender.
Conclusions:
These findings highlight the presence of vascular sequela that last up to 6- and 12-months post-infection and point out the need for preventive measures and patient follow-up.
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