Arterial Stiffness in COVID-19 Along With Persistent Inflammatory Process

Fujioka K

Published on: 2022-09-14

Abstract

Hypertension and aging are 2 major determinants of arterial stiffness and is also independent risk factor for coronavirus disease 2019 (COVID-19) mortality. It is known that COVID-19 can cause early vascular aging and arterial stiffness. Meanwhile, dyslipidemia, diabetes, and obesity are considered as risk factors for endothelial dysfunction and for worse outcomes in COVID-19. The author previously reported that interrelationship among lipid profile, arterial stiffness, and vascular smooth muscle cell (VSMC) function was shown and also described the arterial stiffness in chronic severe inflammation along with Takayasu arteritis. Following acute COVID-19 infection, a patient with physical and neuropsychiatric manifestations lasting longer than 12 weeks is regarded as Long COVID, chronic COVID syndrome or post-acute sequelae of COVID-19. The previous report demonstrated the persistent arterial stiffness, endothelial dysfunction, and high oxidative stress leading to cardiac performances in patients with COVID-19 after 12 months infection. The current knowledge and trends of arterial stiffness in COVID-19 along with persistent inflammatory process will be reviewed in detail. Based on the evidence, the severe inflammation in COVID-19 may affect microvascular dysfunction and contribute to persistent inflammation after COVID-19 infection. It is plausible that the sustained endothelial dysfunction and arterial stiffness along with high oxidative stress lead to cardiac manifestations after COVID-19 infection. Due to persistent endothelial dysfunction and inflammation, in addition to impaired flow-mediated vasodilation (FMD), increased pulse wave velocity (PWV) may be associated with the severity and duration of inflammatory process in COVID-19 patients with persistent clinical manifestations and inflammatory biomarkers, thereby suggesting that the early onset of atherosclerosis in non-cardiovascular disease (CVD) patients and CV outcomes in preexisting CVD patients after COVID-19 are warranted.