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Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/CFS).
Haffke, Milan; Freitag, Helma; Rudolf, Gordon; Seifert, Martina; Doehner, Wolfram; Scherbakov, Nadja; Hanitsch, Leif; Wittke, Kirsten; Bauer, Sandra; Konietschke, Frank; Paul, Friedemann; Bellmann-Strobl, Judith; Kedor, Claudia; Scheibenbogen, Carmen; Sotzny, Franziska.
  • Haffke M; Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany. milan.haffke@charite.de.
  • Freitag H; Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Rudolf G; Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Seifert M; Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Doehner W; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany.
  • Scherbakov N; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
  • Hanitsch L; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany.
  • Wittke K; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
  • Bauer S; Department of Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Konietschke F; Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Paul F; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany.
  • Bellmann-Strobl J; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
  • Kedor C; Department of Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Scheibenbogen C; Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
  • Sotzny F; Institute for Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Berlin, Germany.
J Transl Med ; 20(1): 138, 2022 03 22.
Article in English | MEDLINE | ID: covidwho-1759761
ABSTRACT

BACKGROUND:

Fatigue, exertion intolerance and post-exertional malaise are among the most frequent symptoms of Post-COVID Syndrome (PCS), with a subset of patients fulfilling criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). As SARS-CoV-2 infects endothelial cells, causing endotheliitis and damaging the endothelium, we investigated endothelial dysfunction (ED) and endothelial biomarkers in patients with PCS.

METHODS:

We studied the endothelial function in 30 PCS patients with persistent fatigue and exertion intolerance as well as in 15 age- and sex matched seronegative healthy controls (HCs). 14 patients fulfilled the diagnostic criteria for ME/CFS. The other patients were considered to have PCS. Peripheral endothelial function was assessed by the reactive hyperaemia index (RHI) using peripheral arterial tonometry (PAT) in patients and HCs. In a larger cohort of patients and HCs, including post-COVID reconvalescents (PCHCs), Endothelin-1 (ET-1), Angiopoietin-2 (Ang-2), Endocan (ESM-1), IL-8, Angiotensin-Converting Enzyme (ACE) and ACE2 were analysed as endothelial biomarkers.

RESULTS:

Five of the 14 post-COVID ME/CFS patients and five of the 16 PCS patients showed ED defined by a diminished RHI (< 1.67), but none of HCs exhibited this finding. A paradoxical positive correlation of RHI with age, blood pressure and BMI was found in PCS but not ME/CFS patients. The ET-1 concentration was significantly elevated in both ME/CFS and PCS patients compared to HCs and PCHCs. The serum Ang-2 concentration was lower in both PCS patients and PCHCs compared to HCs.

CONCLUSION:

A subset of PCS patients display evidence for ED shown by a diminished RHI and altered endothelial biomarkers. Different associations of the RHI with clinical parameters as well as varying biomarker profiles may suggest distinct pathomechanisms among patient subgroups.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fatigue Syndrome, Chronic / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Transl Med Year: 2022 Document Type: Article Affiliation country: S12967-022-03346-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Fatigue Syndrome, Chronic / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Transl Med Year: 2022 Document Type: Article Affiliation country: S12967-022-03346-2