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. 2021 Oct;25(10):1113-1119.
doi: 10.5005/jp-journals-10071-24000.

The COSEVAST Study Outcome: Evidence of COVID-19 Severity Proportionate to Surge in Arterial Stiffness

Neeraj Kumar  1 , Sanjeev Kumar  2 , Abhyuday Kumar  3 , Divendu Bhushan  4 , Amarjeet Kumar  1 , Ajeet Kumar  3 , Veena Singh  5 , Prabhat K Singh  6
Affiliations

The COSEVAST Study Outcome: Evidence of COVID-19 Severity Proportionate to Surge in Arterial Stiffness

Neeraj Kumar et al. Indian J Crit Care Med. 2021 Oct.

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection affects the cardiovascular system at many levels. It initially infects endothelial cells, inducing marked endothelial damage and inflammation. However, there was no empirical evidence of functional compromise of arterial walls.

Aims and objective: Our primary objective was to study functional arterial damage in coronavirus disease 2019 (COVID-19) and establish the noninvasive measurement of arterial stiffness as an independent marker of disease severity.

Materials and methods: We recorded the arterial stiffness of 23 mild, 21 moderate, and 20 severe COVID-19 patients grouped on the latest National Institute of Health (NIH) severity criteria. We observed arterial stiffness of COVID-19 patients with standard parameters like noninvasive estimated carotid-femoral pulse wave velocity (cfPWV), age-normalized increase in cfPWV (ANI_cfPWV), age-normalized increase in aortic augmentation pressure (ANI_AugP), and heart rate-normalized augmentation index (HRN_ AIx). All the parameters were also corrected for statistically significant confounding factors.

Results: Moderate and severe COVID-19 patients have extremely significantly elevated arterial stiffness than mild patients. In mild patients, cfPWV (829.1 ± 139.2 cm/second) was significantly lower than both moderate (1067 ± 152.5 cm/second, p <0.0001) and severe (1416 ± 253.9 cm/second, p <0.0001) patients. ANI_cfPWV in moderate and severe patients was significantly higher than mild patients (mild: 101.2 ± 126.1 cm/second; moderate: 279 ± 114.4 cm/second; severe: 580.1 ± 216.4 cm/second; intergroup p <0.0001). The results even after correction for significant confounding factors did not show any considerable change in the increasing trend of arterial stiffness.

Conclusion: This study establishes the functional deterioration of arteries in proportion to the severity of COVID-19.

How to cite this article: Kumar N, Kumar S, Kumar A, Bhushan D, Kumar A, Kumar A, et al. The COSEVAST Study Outcome: Evidence of COVID-19 Severity Proportionate to Surge in Arterial Stiffness. Indian J Crit Care Med 2021;25(10):1113-1119.

Keywords: Arterial stiffness; COVID-19; COVID-19 ARDS; Endothelial injury; Intensive care unit.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Figs 1A to D
Figs 1A to D
It shows cfPWV in all three patient categories, age-normalized increase in cfPWV, age-normalized increase in aortic augmentation pressure, and HR-normalized AIx values
Figs 2A to D
Figs 2A to D
It shows the results of arterial stiffness measurements of COVID-19 patients after correction in graphical format
See this image and copyright information in PMC

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