Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal, ehaf430. https://doi.org/10.1093/eurheartj/ehaf430 Dr. Rosa Maria Bruno et al.
Points
- A multicentric cohort study found that COVID-19 survivors exhibit increased arterial stiffness, a key indicator of accelerated vascular aging, six months after their initial infection.
- This effect was particularly significant in women, who showed substantially higher pulse wave velocity across all severities of infection, from non-hospitalized to ICU-admitted cases.
- The observed increase in arterial stiffness in women is clinically relevant, equivalent to approximately five years of aging, and associated with a higher risk of future cardiovascular disease.
- Among women who had COVID-19, those experiencing persistent long-term symptoms demonstrated significantly higher levels of vascular stiffness compared to those who had fully recovered.
- Follow-up at twelve months suggested that this COVID-induced vascular aging process may stabilize or slightly improve, unlike the expected progression observed in uninfected control groups.
Summary
A prospective, multicentric cohort study involving 2,390 participants investigated the long-term vascular effects of COVID-19. The primary outcome, carotid-femoral pulse wave velocity (PWV), was measured 6 ± 3 months post-infection across four groups: COVID-negative controls and three COVID-positive groups based on hospitalization severity (none, general ward, or ICU). After adjusting for confounders, all three COVID-19-positive groups showed significantly higher PWV compared to the control group’s adjusted mean of 7.53 m/s (95% CI, 7.09-7.97). The respective increases were +0.41 m/s (P < .001), +0.37 m/s (P = .001), and +0.40 m/s (P = .003).
Sex-stratified analyses revealed this effect was exclusive to women. Compared to controls, women with prior COVID-19 had significantly elevated PWV, with increases of 0.55 m/s, 0.60 m/s, and 1.09 m/s for the non-hospitalized, ward-admitted, and ICU-admitted groups, respectively (P < .001 for all). An increase of 0.5 m/s is considered clinically equivalent to approximately five years of vascular aging. Furthermore, among COVID-positive women, those with persistent symptoms had a significantly higher adjusted PWV of 7.52 m/s (95% CI, 7.09-7.96) compared to 7.13 m/s (95% CI, 6.67-7.59) in those without symptoms (P < .001).
The study concludes that COVID-19 is associated with accelerated vascular aging, particularly in women, regardless of initial disease severity. While follow-up at 12 months indicated that this accelerated aging process stabilized or slightly improved in the COVID-positive groups, the initial damage highlights a potential mechanism for long-term cardiovascular complications post-infection. These findings underscore the importance of cardiovascular risk monitoring and management in individuals who have recovered from COVID-19, especially women with persistent symptoms.
Link to the article: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf430/8236450
References Bruno, R. M., Badhwar, S., Abid, L., Agharazii, M., Anastasio, F., Bellien, J., Burghuber, O., Faconti, L., Filipovsky, J., Ghiadoni, L., Giannattasio, C., Hametner, B., Hughes, A. D., Jeroncic, A., Ikonomidis, I., Lonnebakken, M. T., Maloberti, A., Mayer, C. C., Muiesan, M. L., … Bates, L. (2025). Accelerated vascular ageing after COVID-19 infection: The CARTESIAN study. European Heart Journal, ehaf430. https://doi.org/10.1093/eurheartj/ehaf430
