Endothelial dysfunction in acute and long standing COVID-19: A prospective cohort study

Background: Coronavirus disease-19 (COVID-19) is implicated by active endotheliitis, and cardiovascular morbidity. The long-COVID-19 syndrome implications in atherosclerosis have not been elucidated yet. We assessed the immediate, intermediate, and long-term effects of COVID-19 on endothelial function.& nbsp;Methods: In this prospective cohort study, patients hospitalized for COVID-19 at the medical ward or Intensive Care Unit (ICU) were enrolled and followed up to 6 months post-hospital discharge. Medical history and labo-ratory examinations were performed while the endothelial function was assessed by brachial artery flow-mediated dilation (FMD). Comparison with propensity score-matched cohort (control group) was performed at the acute (upon hospital admission) and follow-up (1 and 6 months) stages.& nbsp;Results: Seventy-three patients diagnosed with COVID-19 (37% admitted in ICU) were recruited. FMD was significantly (p < 0.001) impaired in the COVID-19 group (1.65 +/- 2.31%) compared to the control (6.51 +/- 2.91%). ICU-treated subjects presented significantly impaired (p = 0.001) FMD (0.48 +/- 1.01%) compared to those treated in the medical ward (2.33 +/- 2.57%). During hospitalization, FMD was inversely associated with Interleukin-6 and Troponin I (p < 0.05 for all). Although, a significant improvement in FMD was noted during the follow-up (acute: 1.75 +/- 2.19% vs. 1 month: 4.23 +/- 2.02%, vs. 6 months: 5.24 +/- 1.62%; p = 0.001), FMD remained impaired compared to control (6.48 +/- 3.08%) at 1 month (p < 0.001) and 6 months (p = 0.01) post-hospital discharge.& nbsp;Conclusion: COVID-19 patients develop a notable endothelial dysfunction, which is progressively improved over a 6-month follow-up but remains impaired compared to healthy controls subjects. Whether chronic dysregulation of endothelial function following COVID-19 could be accompanied by a residual risk for cardiovascular and thrombotic events merits further research.

Automated summary

In this study, the immediate, intermediate, and long-term effects of COVID-19 on endothelial function were assessed. The results showed that COVID-19 patients developed endothelial dysfunction, which improved over a 6-month follow-up but remained impaired compared to healthy controls. Further research is needed to investigate whether the chronic dysregulation of endothelial function following COVID-19 is associated with a residual risk for cardiovascular and thrombotic events.