Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina.
Am J Physiol Heart Circ Physiol. 2021 Jan 1;320(1):H404-H410. doi: 10.1152/ajpheart.00897.2020. Epub 2020 Dec 11.
While SARS-CoV-2 primarily affects the lungs, the virus may be inflicting detriments to the cardiovascular system, both directly through angiotensin-converting enzyme 2 receptor and initiating systemic inflammation. Persistent systemic inflammation may be provoking vascular dysfunction, an early indication of cardiovascular disease risk. To establish the potential effects of SARS-CoV-2 on the systemic vasculature in the arms and legs, we performed a cross-sectional analysis of young healthy adults (control: 5 M/15 F, 23.0 ± 1.3 y, 167 ± 9 cm, 63.0 ± 7.4 kg) and young adults who, 3-4 wk prior to testing, had tested positive for SARS-CoV-2 (SARS-CoV-2: 4 M/7 F, 20.2 ± 1.1 y, 172 ± 12 cm, 69.5 ± 12.4 kg) (means ± SD). Using Doppler ultrasound, brachial artery flow-mediated dilation (FMD) in the arm and single passive limb movement (sPLM) in the leg were assessed as markers of vascular function. Carotid-femoral pulse wave velocity (PWVcf) was asvsessed as a marker of arterial stiffness. FMD was lower in the SARS-CoV-2 group (2.71 ± 1.21%) compared with the control group (8.81 ± 2.96%) ( < 0.01) and when made relative to the shear stimulus (SARS-CoV-2: 0.04 ± 0.02 AU, control: 0.13 ± 0.06 AU, < 0.01). The femoral artery blood flow response, as evidenced by the area under the curve, from the sPLM was lower in the SARS-CoV-2 group (-3 ± 91 mL) compared with the control group (118 ± 114 mL) ( < 0.01). PWVcf was higher in the SARS-CoV-2 group (5.83 ± 0.62 m/s) compared with the control group (5.17 ± 0.66 m/s) ( < 0.01). Significantly lower systemic vascular function and higher arterial stiffness are evident weeks after testing positive for SARS-CoV-2 among young adults compared with controls. This study was the first to investigate the vascular implications of contracting SARS-CoV-2 among young, otherwise healthy adults. Using a cross-sectional design, this study assessed vascular function 3-4 wk after young adults tested positive for SARS-CoV-2. The main findings from this study were a strikingly lower vascular function and a higher arterial stiffness compared with healthy controls. Together, these results suggest rampant vascular effects seen weeks after contracting SARS-CoV-2 in young adults.
虽然 SARS-CoV-2 主要影响肺部，但该病毒可能通过血管紧张素转换酶 2 受体直接损害心血管系统，并引发全身炎症。持续的全身炎症可能会引发血管功能障碍，这是心血管疾病风险的早期迹象。为了确定 SARS-CoV-2 对四肢系统血管的潜在影响，我们对年轻健康成年人（对照组：5 名男性/15 名女性，23.0±1.3 岁，167±9cm，63.0±7.4kg）和在检测前 3-4 周检测出 SARS-CoV-2 阳性的年轻成年人（SARS-CoV-2 组：4 名男性/7 名女性，20.2±1.1 岁，172±12cm，69.5±12.4kg）进行了横断面分析。使用多普勒超声评估臂部肱动脉血流介导的扩张（FMD）和腿部单被动肢体运动（sPLM）作为血管功能的标志物。颈动脉-股动脉脉搏波速度（PWVcf）作为动脉僵硬度的标志物。与对照组（8.81±2.96%）相比，SARS-CoV-2 组的 FMD 较低（2.71±1.21%）（ < 0.01），并且相对于剪切刺激（SARS-CoV-2：0.04±0.02AU，对照组：0.13±0.06AU）（ < 0.01）。与对照组（118±114mL）相比，SARS-CoV-2 组的股动脉血流反应（由 sPLM 产生的曲线下面积）较低（-3±91mL）（ < 0.01）。与对照组（5.17±0.66m/s）相比，SARS-CoV-2 组的 PWVcf 较高（5.83±0.62m/s）（ < 0.01）。与对照组相比，SARS-CoV-2 组的系统性血管功能明显降低，动脉僵硬度明显升高。与对照组相比，在感染 SARS-CoV-2 后数周，年轻成年人的血管功能明显降低，动脉僵硬度明显升高。这项研究首次调查了在年轻、健康的成年人中感染 SARS-CoV-2 后的血管影响。本研究采用横断面设计，在感染 SARS-CoV-2 后 3-4 周评估血管功能。这项研究的主要发现是与健康对照组相比，血管功能明显降低，动脉僵硬度升高。这些结果表明，在年轻成年人感染 SARS-CoV-2 数周后，会出现广泛的血管效应。
