ABSTRACT
Background: Endotheliilitis COVID-19 related endothelial dysfunction plays a key role in the cardiovascular complications of the disease. Vaccine against SARS-CoV-2 protects against severe COVID-19 and from adverse effects. We evaluated the impact of vaccination on COVID-19 induced endothelial dysfunction. Method(s): We enrolled 45 patients hospitalized for COVID-19 (either vaccinated or not against SARS-CoV-2). Clinical information and laboratory findings were collected, and brachial artery flow-mediated dilation (FMD) was evaluated as a measure of endothelial function. Subjects without COVID- 19 were used as the control group. All patients were hospitalized in a medical ward classified according to the World Health Organization (WHO) scale. Result(s): There was no difference in age (62+/-10 years vs. 65+/-8 years, p=0.12) and male sex prevalence (56% vs. 49%, p=0.53) between patients with COVID-19 and control subjects. Of the patients with COVID-19, 44% (20) were vaccinated against SARS-CoV-2. FMD was impaired in patients with COVID-19 compared to controls (4.35+/-3.56% vs. 7.36+/-2.91%, p<0.001). In patients with COVID-19, FMD was impaired in non-vaccinated subjects compared to vaccinated (2.05+/-2.41% vs. 7.24+/-2.52%, p<0.001). There was no difference in FMD between controls and vaccinated against COVID-19 patients (7.36+/-2.91% vs. 7.24+/-2.52%, p=0.86). There was no difference in the WHO scale clinical status for vaccinated and not vaccinated COVID-19 subjects (For Vaccinated WHO scale 3: 35%;scale 4: 35%;scale 5: 30% vs. For Non-vaccinated WHO scale 3: 20;scale 4: 60%;scale 5: 20%, p=0.24). Conclusion(s): Hospitalized patients with COVID-19 present endothelial dysfunction in the acute phase of the disease. Endothelial function in unvaccinated patients with COVID-19 is impaired compared to control subjects as well as compared to vaccinated patients with COVID-19. This data provides insights on the protective role of vaccination against COVID-19 related endotheliitis. (Figure Presented) .
ABSTRACT
Background: Long COVID-19 syndrome is an increasingly recognized problem. Post-infectious cardiac autonomic dysfunction is commonly reported. This study aims to evaluate autonomic dysfunction by means of Heart rate variability (HRV) on post-COVID-19 patients. Methods: Hospitalized patients for COVID-19 (either at the medical ward or Intensive Care Unit (ICU)) were followed up at 1 and 6 months after hospital discharge. Medical history and clinical information were collected. HRV was assessed by 24-hour ambulatory electrocardiography Holter, with the measure of the standard deviation of normal RR intervals in 24 h, ms (SDNN). The comparison was conducted with age and sex-matched non-COVID-19 controls. Results: Thirty-four patients hospitalized with COVID-19 (20.6% admitted in ICU) were examined 1-month and 6-months post-hospital discharge. SDNN was significantly (p<0.001) reduced in the COVID-19 group (111±23 ms) compared to the control subjects (152±24 ms) 1-month after discharge. Subgroup analysis between COVID-19 group revealed that ICU subjects presented significantly (p<0.001) reduced SDNN compared to the medical ward, respectively (83±20 ms vs. 118±17 ms). At 6-months, an improvement was noted at SDNN 24h (6-month: 133±24 vs. control: 151±24 ms, p=0.004;1-month: 111±23 ms vs. 6-month: 133±24 ms, p<0.001). Also at 6-months, ICU subjects noted significantly (p=0.003) reduced SDNN 24h compared to medical ward subjects (107±17 ms vs. 140±20 ms). On the 6-months follow-up, 32% of the subjects had “long-COVID-19” symptoms. Subjects with long COVID-19 symptoms had low SDNN values (“long-COVID-19”: 112±17 ms vs. non-“long-COVID-19”: 142±20 ms, p=0.001) Conclusion: Patients hospitalized for COVID-19 have reduced SDNN, at one month post-hospital discharge which is improved at the six months follow-up. These findings emphasize the increased sympathetic drive activity in the post-acute COVID-19 phase and imply a link between autonomic dysfunction and long COVID-19. Funding Acknowledgement: Type of funding sources: None.Figure 1. SDNN (ms) at one monthFigure 2. SDNN (ms) at six months