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: Myocardial and vascular alterations among post-COVID-19 patients are observed. The coupling between arterial stiffness with left ventricular (LV) myocardial function (ventricular-arterial coupling, VAC) is an important determinant of cardiovascular performance and cardiac energetics. The aim of the study was to investigate the spectrum of cardiac and vascular abnormalities at mid-term follow-up in post-COVID-19 patients. Methods: We enrolled 25 hospitalized patients for COVID-19, at one and six months after hospital discharge. The ratio (PWV/GLS) of carotid-femoral pulse wave velocity (cf-PWV), as a marker of arterial stiffness, to global longitudinal strain (LV-GLS), as a marker of left ventricular performance, was estimated as a marker of arterial elastance/left ventricular elastance index the long-term. The comparison was conducted with age and sex-matched non-COVID-19 controls. Results: There was no difference in age (56.8±11.6 y vs. 57.4±9.5 y;p=0.85) and male sex (64% vs. 68%;P=0.76) between post-COVID-19 and control subjects respectively. At one-month follow-up, significant impairment was noted between post-COVID-19 and control subjects regarding: VAC (−0.71±0.24 m/s% vs. −0.44±0.11 m/sec%;p<0.001), LV-GLS (−17.9±3.1% vs. −21.9±2.7%;p<0.001), cf-PWV (12.3±3.5 m/s vs. 9.6±1.9;p<0.001). At six-month follow-up, an improvement was observed but there still was significant difference between post-COVID-19 and control subjects in: VAC (−0.62±0.19 m/sec% vs. −0.44±0.11 m/sec%;p<0.001), LV-GLS (−19.3±2.9% vs. −21.9±2.7%;p=0.001), cf-PWV (11.7±2.7 m/s vs. 9.6±1.9 m/s;p=0.001). Moreover, it was observed at 1-month: VAC adverse correlation with the levels of IL-6 (r=−0.54;p<0.001), CRP (−0.71;p=0.011) and at 6-months: IL-6 (r=−0.47;p=0.003), CRP (−0.56;p=0.007). Conclusion: Ventricular-arterial coupling is impaired 6 months following COVID-19 highlighting the possible effects of SARS-CoV-2 infection in left ventricular mechanics and performance. Funding Acknowledgement: Type of funding sources: None.Figure 1. VAC, IL-6 and CRPFigure 2. cf-PWV, LV-GLS