Long-term angiogenic and thromboinflammatory signatures in post-COVID-19 syndrome
Arlette Araceli Mora Zetina1,2, Erika Fabiola Ortega Sanchez1,2, Brenda Saraí Zuñiga Ascencio3,4
1Laboratorio de Investigación en Epidemiología e Infectología, Departamento de Investigación en EPOC y Tabaquismo, Instituto Nacional de Enfermedades Respiratorias, "Ismael Cosio Villegas", Calzada de Tlalpan 4502, 14080, Ciudad de México, México.
Insights
Long COVID survivors often experience persistent symptoms due to ongoing angiogenic and thromboinflammatory dysfunction. Biomarkers like vascular endothelial growth factor D and angiopoietin-1 remain elevated, indicating long-term vascular issues.
Area of Science:
- Cardiovascular Science
- Immunology
- Infectious Diseases
Background:
- Post-COVID-19 syndrome is a significant long-term consequence of severe SARS-CoV-2 infection.
- It may involve persistent angiogenic and thromboinflammatory dysfunction.
- Long-term behavior of relevant biomarkers is not well understood.
Purpose of the Study:
- To investigate the evolution of angiogenic and thromboinflammatory biomarkers in patients with post-COVID-19 syndrome.
- To correlate biomarker changes with persistent symptoms.
Main Methods:
- An ambispective cohort study followed 32 adults hospitalized for severe/critical COVID-19 for 3.5 years.
- Plasma samples were collected during hospitalization and long-term follow-up.
- Key biomarkers assessed included vascular endothelial growth factor D, angiopoietin-1, alpha-2-macroglobulin, and prothrombin time.
Main Results:
- Persistent symptoms like fatigue and dyspnea were common at 3.5 years.
- Elevated vascular endothelial growth factor D and angiopoietin-1 were observed.
- Increased alpha-2-macroglobulin and prolonged prothrombin time were noted in a subset of patients.
Conclusions:
- Severe COVID-19 survivors exhibit sustained angiogenic dysregulation and thromboinflammatory imbalance.
- Elevated biomarkers suggest ongoing vascular perturbations and coagulation disturbances.
- These biomarkers may aid in identifying long-term vascular alterations in post-COVID-19 syndrome.
Background:
Post-COVID-19 syndrome is a major long-term sequela of severe SARS-CoV-2 infection, potentially involving persistent angiogenic and thromboinflammatory dysfunction, though long-term biomarker behavior remains unclear.
Objective:
To evaluate the evolution of angiogenic and thromboinflammatory biomarkers in post-COVID-19 syndrome patients.
Methods:
This ambispective cohort study was conducted at the National Institute of Respiratory Diseases in Mexico City. Thirty-two adults hospitalized for severe or critical COVID-19 in 2020 were followed for three and a half years. Paired plasma samples were collected during hospitalization and at long-term follow-up. Endothelial dysfunction markers included soluble P-selectin, vascular endothelial growth factor receptor 2, vascular endothelial growth factor D, and angiopoietin-1. Hemostasis was assessed by prothrombin time. Acute-phase proteins alpha-2-macroglobulin and haptoglobin were measured via immunoassay. Persistent symptoms were documented at follow-up.
Results:
At three and a half years, persistent symptoms were common: fatigue in sixty-five point 6%, dyspnea in sixty-two point 5%, and concentration difficulties in sixty-five point 6%. Vascular endothelial growth factor D and angiopoietin-1 remained elevated. Alpha-2-macroglobulin stayed high, and prothrombin time was prolonged in a subset of patients.
Conclusions:
Severe COVID-19 survivors show sustained angiogenic dysregulation and thromboinflammatory imbalance. Elevated vascular endothelial growth factor D and angiopoietin-1 indicate ongoing angiogenic perturbations, while increased alpha-2-macroglobulin and prolonged prothrombin time reflect persistent coagulation disturbances. These biomarkers may help identify long-term vascular alterations in post-COVID-19 syndrome.
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