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Persistent Endothelial Dysfunction in COVID-19 Survivors Late After Recovery

Front Med 2022 Feb 14;9:809033 Persistent Endothelial Dysfunction in COVID-19 Survivors Late After Recovery Yi-Ping Gao 1, Wei Zhou 1, Pei-Na Huang 1, Hong-Yun Liu 1, Xiao-Jun Bi 1, Ying Zhu 1, Jie Sun 1, Qiao-Ying Tang 1, Li Li 1, Jun Zhang 1, Wei-Hong Zhu 1, Xue-Qing Cheng 1, Ya-Ni Liu 1, You-Bin Deng 1

Affiliation • 1Department of Medical Ultrasound, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Abstract Background: Coronavirus disease 2019 (COVID-19) can result in an endothelial dysfunction in acute phase. However, information on the late vascular consequences of COVID-19 is limited. Methods: Brachial artery flow-mediated dilation (FMD) examination were performed, and inflammatory biomarkers were assessed in 86 survivors of COVID-19 for 327 days (IQR 318-337 days) after recovery. Comparisons were made with 28 age-matched and sex-matched healthy controls and 30 risk factor-matched patients. Results: Brachial artery FMD was significantly lower in the survivors of COVID-19 than in the healthy controls and risk factor-matched controls [median (IQR) 7.7 (5.1-10.7)% for healthy controls, 6.9 (5.5-9.4)% for risk factor-matched controls, and 3.5(2.2-4.6)% for COVID-19, respectively, p < 0.001]. The FMD was lower in 25 patients with elevated tumor necrosis factor (TNF)-α [2.7(1.2-3.9)] than in 61 patients without elevated TNF-α [3.8(2.6-5.3), p = 0.012]. Furthermore, FMD was inversely correlated with serum concentration of TNF-α (r = -0.237, p = 0.007). Conclusion: Survivors of COVID-19 have a reduced brachial artery FMD, which is inversely correlated with increased serum concentration of TNF-α. Prospective studies on the association of endothelial dysfunction with long-term cardiovascular outcomes, especially the early onset of atherosclerosis, are warranted in survivors of COVID-19. Keywords: COVID-19; TNF-α; endothelial function; flow-mediated dilation; inflammation.


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