Vascular alterations among young adults with SARS-CoV-2

Abstract

While SARS-CoV-2 primarily affects the lungs, the virus may be inflicting detriments to the cardiovascular system, both directly through angiotensin-converting enzyme 2 receptor and initiating systemic inflammation. Persistent systemic inflammation may be provoking vascular dysfunction, an early indication of cardiovascular disease risk. To establish the potential effects of SARS-CoV-2 on the systemic vasculature in the arms and legs, we performed a cross-sectional analysis of young healthy adults (control: 5 M/15 F, 23.0 ± 1.3 y, 167 ± 9 cm, 63.0 ± 7.4 kg) and young adults who, 3-4 wk prior to testing, had tested positive for SARS-CoV-2 (SARS-CoV-2: 4 M/7 F, 20.2 ± 1.1 y, 172 ± 12 cm, 69.5 ± 12.4 kg) (means ± SD). Using Doppler ultrasound, brachial artery flow-mediated dilation (FMD) in the arm and single passive limb movement (sPLM) in the leg were assessed as markers of vascular function. Carotid-femoral pulse wave velocity (PWVcf) was asvsessed as a marker of arterial stiffness. FMD was lower in the SARS-CoV-2 group (2.71 ± 1.21%) compared with the control group (8.81 ± 2.96%) (P < 0.01) and when made relative to the shear stimulus (SARS-CoV-2: 0.04 ± 0.02 AU, control: 0.13 ± 0.06 AU, P < 0.01). The femoral artery blood flow response, as evidenced by the area under the curve, from the sPLM was lower in the SARS-CoV-2 group (-3 ± 91 mL) compared with the control group (118 ± 114 mL) (P < 0.01). PWVcf was higher in the SARS-CoV-2 group (5.83 ± 0.62 m/s) compared with the control group (5.17 ± 0.66 m/s) (P < 0.01). Significantly lower systemic vascular function and higher arterial stiffness are evident weeks after testing positive for SARS-CoV-2 among young adults compared with controls.NEW & NOTEWORTHY This study was the first to investigate the vascular implications of contracting SARS-CoV-2 among young, otherwise healthy adults. Using a cross-sectional design, this study assessed vascular function 3-4 wk after young adults tested positive for SARS-CoV-2. The main findings from this study were a strikingly lower vascular function and a higher arterial stiffness compared with healthy controls. Together, these results suggest rampant vascular effects seen weeks after contracting SARS-CoV-2 in young adults.

Keywords: COVID-19; SARS-CoV-2; flow-mediated dilation; passive limb movement; pulse wave velocity.

Figure 1.

Brachial artery flow-mediated dilation (FMD) expressed as percentage change (A) and normalized to shear (B). Two-tailed Student’s t tests for two samples of equal variance were performed between control (n = 5 M/15 F) and SARS-CoV-2 (n = 4 M/7 F) groups. *P < 0.01, between groups. Data are means ± SD.

Figure 2.

Single passive limb movement. Common femoral artery blood flow change from baseline following a single passive limb movement (A) with the 60-s area under the curve (B). Two-tailed Student’s t tests for two samples of equal variance were performed between control (n = 5 M/15 F) and SARS-CoV-2 (n = 4 M/7 F) groups. *P < 0.01, between groups. Data are means ± SD.

Figure 3.

Carotid-femoral pulse wave velocity. Two-tailed Student’s t tests for two samples of equal variance were performed between control (n = 5 M/15 F) and SARS-CoV-2 (n = 4 M/7 F) groups. *P < 0.01, between groups. Data are means ± SD.