Sustained inflammation, coagulation activation and elevated endothelin-1 levels without macrovascular dysfunction at 3 months after COVID-19.
Thromb Res
; 209: 106-114, 2022 01.
Article
in English
| MEDLINE | ID: covidwho-1550090
ABSTRACT
INTRODUCTION:
Endothelial damage and thrombosis caused by COVID-19 may imperil cardiovascular health. More than a year since the WHO declared COVID-19 pandemic, information on its effects beyond the acute phase is lacking. We investigate endothelial dysfunction, coagulation and inflammation, 3 months post-COVID-19. MATERIALS ANDMETHODS:
A cohort study was conducted including 203 patients with prior COVID-19. Macrovascular dysfunction was assessed by measuring the carotid artery diameter in response to hand immersion in ice-water. A historic cohort of 312 subjects served as controls. Propensity score matching corrected for baseline differences. Plasma concentrations of endothelin-1 were measured in patients post-COVID-19, during the acute phase, and in matched controls. Coagulation enzymeinhibitor complexes and inflammatory cytokines were studied. RESULTS ANDCONCLUSIONS:
The prevalence of macrovascular dysfunction did not differ between the COVID-19 (18.6%) and the historic cohort (22.5%, RD -4%, 95%CI -15-7, p = 0.49). Endothelin-1 levels were significantly higher in acute COVID-19 (1.67 ± 0.64 pg/mL) as compared to controls (1.24 ± 0.37, p < 0.001), and further elevated 3 months post-COVID-19 (2.74 ± 1.81, p < 0.001). Thrombinantithrombin(AT) was high in 48.3%. Markers of contact activation were increased in 16-30%. FVIIaAT (35%) and Von Willebrand Factorantigen (80.8%) were elevated. Inflammatory cytokine levels were high in a majority interleukin(IL)-18 (73.9%), IL-6 (47.7%), and IL-1ra (48.9%). At 3 months after acute COVID-19 there was no indication of macrovascular dysfunction; there was evidence, however, of sustained endothelial cell involvement, coagulation activity and inflammation. Our data highlight the importance of further studies on SARS-CoV-2 related vascular inflammation and thrombosis, as well as longer follow-up in recovered patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Endothelin-1
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Thromb Res
Year:
2022
Document Type:
Article
Affiliation country:
J.thromres.2021.11.027
Similar
MEDLINE
...
LILACS
LIS