The relationship of arterial stiffness with disease severity in patients with COVID-19

Aim: Endothelial dysfunction plays an important role in the pathogenesis of target organ damage associated with COVID-19. Cardiovascular complications (CV) due to strong inflammatory damage are more common in critically severe COVID-19 patients than in mildly severe patients. In this study, we aimed to investigate whether the relationship between infection severity and arterial stiffness (AS) in patients with COVID-19 could be a predictor of future CV events. Material and Method: According to the severity of COVID-19, the patients were divided into two groups as inpatient (severe group) and outpatient (mild group). The control group that is matched for gender and cardiac risk factors was included in the study. AS and echocardiographic measurements were performed as standard in all groups in the first month of post-COVID period. The biochemical parameters (glucose, complete blood count, C-Reactive Protein, hs-troponin-T) of the patients were obtained retrospectively from the hospital database. Results: A total of 84 patients, 27 of whom were in the control, 32 in the mild disease and 25 in the severe disease groups, were included in the study. The mean age of the entire population was 48.68±12.9 years, and 58 (69%) were male. In our study, hypertension was detected at a rate of 35.7%, diabetes mellitus at a rate of 11.9%, and coronary artery disease and smoking at a rate of 13.1%, and there was no statistical difference between the groups in terms of these risk factors. The mean pulse wave velocity (PWV) values obtained in AS measurements were 8.02 m/s in the control group, 8.07 m/s in the mild disease group and 8.75 m/s in the severe disease group. These values were found to be statistically significant when the control and mild disease groups were compared with the severe group (p=0.007, p=0.008, respectively). However, there was no statistical difference between the mild disease and control group (p=0.681). Conclusion: Our study showed that patients admitted to the intensive care unit for COVID-19 infection have severe biochemical abnormalities, subclinical myocardial damage, and increased AS, as evidenced by high PWV values, due to strong inflammatory damage, and that damage to the vascular endothelium may be a predictor of future increased CV events for these patients.