Podrug Mario, Koren Pjero, Dražić Maras Edita, Podrug Josip, Čulić Viktor, Perissiou Maria, Bruno Rosa Maria, Mudnić Ivana, Boban Mladen, Jerončić Ana
Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia.
University Department of Health Studies, University of Split, 21000 Split, Croatia.
J Clin Med. 2023 Mar 8;12(6):2123. doi: 10.3390/jcm12062123.
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 (p ≤ 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.
与新冠病毒相关的血管疾病并发症主要与内皮功能障碍有关；然而，该疾病对血管结构和功能的影响，尤其是长期影响（感染后>7周），仍有待探索。我们对诊断为轻症新冠病毒感染的患者进行了感染前后动脉僵硬度以及中心和全身血流动力学参数的个体变化测量。作为实验室观察性研究的一部分，基线测量在感染前两年内进行，而感染后测量在新冠病毒感染发病后2-3个月进行。我们在整个研究中使用相同的测量方案以及线性和混合效应回归模型来分析数据。患者（N = 32）主要为健康年轻人（平均年龄±标准差：36.6±12.6）。我们发现，动脉僵硬度和中心血流动力学的各种参数——颈股脉搏波速度（cfPWV）、心率75次/分时的增强指数（AIx@HR75）、中心舒张压（cDBP）以及舒张压（DBP）和平均动脉压（MAP）——对轻症新冠病毒感染有反应。这些反应的程度取决于新冠病毒感染发病后的时间以及年龄（p≤0.013）。事实上，混合效应模型预测感染后2-3个月内血管损伤会出现具有临床意义的进展（cfPWV增加1.4米/秒，AIx@HR75增加15%，DBP、cDBP和MAP约增加8 mmHg）。结果表明，轻症新冠病毒感染后血管系统存在广泛且持久的病理过程，个体反应存在异质性，其中一些可能由针对新冠病毒的自身免疫反应触发。
