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Long-Term Adverse Effects of Mild COVID-19 Disease on Arterial Stiffness, and Systemic and Central Hemodynamics: A Pre-Post Study, 2023, Podrug et al.

Discussion in 'Long Covid research' started by SNT Gatchaman, May 30, 2023.

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  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Long-Term Adverse Effects of Mild COVID-19 Disease on Arterial Stiffness, and Systemic and Central Hemodynamics: A Pre-Post Study
    Podrug, Mario; Koren, Pjero; Dražić Maras, Edita; Podrug, Josip; Čulić, Viktor; Perissiou, Maria; Bruno, Rosa Maria; Mudnić, Ivana; Boban, Mladen; Jerončić, Ana

    COVID-19-associated vascular disease complications are primarily associated with endothelial dysfunction; however, the consequences of disease on vascular structure and function, particularly in the long term (>7 weeks post-infection), remain unexplored.

    Individual pre and post-infection changes in arterial stiffness as well as central and systemic hemodynamic parameters were measured in patients diagnosed with mild COVID-19. As part of in-laboratory observational studies, baseline measurements were taken up to two years before, whereas the post-infection measurements were made 2–3 months after the onset of COVID-19. We used the same measurement protocol throughout the study as well as linear and mixed-effects regression models to analyze the data. Patients (N = 32) were predominantly healthy and young (mean age ± SD: 36.6 ± 12.6).

    We found that various parameters of arterial stiffness and central hemodynamics—cfPWV, AIx@HR75, and cDBP as well as DBP and MAP—responded to a mild COVID-19 disease. The magnitude of these responses was dependent on the time since the onset of COVID-19 as well as age (pregression_models ≤ 0.013). In fact, mixed-effects models predicted a clinically significant progression of vascular impairment within the period of 2–3 months following infection (change in cfPWV by +1.4 m/s, +15% in AIx@HR75, approximately +8 mmHg in DBP, cDBP, and MAP).

    The results point toward the existence of a widespread and long-lasting pathological process in the vasculature following mild COVID-19 disease, with heterogeneous individual responses, some of which may be triggered by an autoimmune response to COVID-19.

    Link | PDF (Journal of Clinical Medicine)
     
    SNT Gatchaman, May 30, 2023
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  2. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    32 patients standardised vascular assessments, pre- and post- mild Covid infection. The interesting part is the demonstration that vascular changes increased with time from infection.

    The authors speculate that this could be due to development of auto-antibodies.

     
    SNT Gatchaman, May 30, 2023
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  3. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    SNT Gatchaman, May 30, 2023
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  4. Sean

    Sean Moderator Staff Member

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    This is indeed an interesting result. :geek::nerd::bookworm:
     
    Sean, May 31, 2023
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  5. Hutan

    Hutan Moderator Staff Member

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    Croatian research

    So, for that way of assessing difference, they didn't find any difference in arterial stiffness between the pre and post-infection measurements. Have a look at Table 2. - it shows that the mean pre and post values for virtually all of the measures are very similar.

    Screen Shot 2023-05-31 at 6.36.36 pm.png
    Figure 2 is the time since Covid infection against the change in arterial stiffness, normalised to a heart rate of 75 bpm. This is what they are reporting as the significant finding. There could be a relationship, but it's also possible it's just chance. The range of sampling was around 52 to 94 days after infection.

    The 32 people aren't reported as having any post-Covid symptoms. I find it odd that the arterial stiffness gets worse over time in these healthy people. Even people with Long COVID tend, on average, to improve over time in that first year.

    When I participated in a 2 xCPET experiment, my arterial stiffness was assessed (a brachial artery measure) and it came out significantly more stiff than would be expected for a woman of my age. I'm not sure that the arterial stiffness findings were ever published. The student who did the measure was quite nervous and I wasn't entirely sure if teh measurement had been done correctly. Part of that doubt might be me not wanting to believe that I have high arterial stiffness. Pre-ME/CFS I had been fairly fit, and even at the time of the CPETs, I still had a healthy BMI.

    All that is to say, I think it's possible that an infection can have an impact on arterial stiffness. It was great that these authors thought to use the pre-Covid data they had to devise this study and I hope that there will be studies that track arterial stiffness after Covid-19 over time in people with Long Covid. But, I'm a bit hesitant to think this result will be replicated, in people with no Long Covid symptoms at least.

     
    Last edited: May 31, 2023
    Hutan, May 31, 2023
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