Six-month longitudinal tracking of arterial stiffness and blood pressure in young adults following SARS-CoV-2 infection

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can increase arterial stiffness 3-4 wk following infection, even among young, healthy adults. However, the long-term impacts of SARS-CoV-2 infection on cardiovascular health and the duration of recovery remain unknown. The purpose of this study was to elucidate potential long-lasting effects of SARS-CoV-2 infection on markers of arterial stiffness among young adults during the 6 mo following infection. Assessments were performed at months 1, 2, 3, 4, and ∼6 following SARS-CoV-2 infection. Doppler ultrasound was used to measure carotid-femoral pulse wave velocity (cfPWV) and carotid stiffness, and arterial tonometry was used to measure central blood pressures and aortic augmentation index at a heart rate of 75 beats·min^-1 (AIx@HR75). Vascular (VCAM-1) and intracellular (ICAM-1) adhesion molecules were analyzed as circulating markers of arterial stiffness. From months 1-6, a significant reduction in cfPWV was observed (month 1: 5.70 ± 0.73 m·s^-1; month 6: 4.88 ± 0.65 m·s^-1; P < 0.05) without any change in carotid stiffness measures. Reductions in systolic blood pressure (month 1: 123 ± 8 mmHg; month 6: 112 ± 11 mmHg) and mean arterial pressure (MAP; month 1: 97 ± 6 mmHg; month 6: 86 ± 7 mmHg) were observed (P < 0.05), although AIx@HR75 did not change over time. The month 1-6 change in cfPWV and MAP were correlated (r = 0.894; P < 0.001). A reduction in VCAM-1 was observed at month 3 compared with month 1 (month 1: 5,575 ± 2,242 pg·mL^-1; month 3: 4,636 ± 1,621 pg·mL^-1; P < 0.05) without a change in ICAM-1. A reduction in cfPWV was related with MAP, and some indicators of arterial stiffness remain elevated for several months following SARS-CoV-2 infection, possibly contributing to prolonged recovery and increased cardiovascular health risks.NEW & NOTEWORTHY We sought to investigate potential long-lasting effects of SARS-CoV-2 infection on markers of arterial stiffness among young adults for 6 mo following infection. Carotid femoral pulse wave velocity was significantly reduced while carotid stiffness measures remained unaltered over the 6-mo period. These findings suggest several months of recovery from infection may be necessary for young adults to improve various markers of arterial stiffness, possibly contributing to cardiovascular health and recovery among those infected with SARS-CoV-2.

Keywords: COVID-19; arterial stiffness; blood pressure; carotid stiffness; pulse wave velocity.

Graphical abstract

Figure 1.

Carotid-femoral pulse wave velocity (A), carotid-radial pulse wave velocity (B), and central blood pressures (C) in young adults with SARS-CoV-2. Month 1: 25 ± 6 days after positive SARS-CoV-2 test, n = 14 (7 M/7 F); month 2: 57 ± 7 days, n = 14 (7 M/7 F); month 3: 87 ± 8 days, n = 12 (7 M/5 F); month 4: 119 ± 13 days, n = 13 (7 M/6 F); month 6: 174 ± 15 days, n = 12 (7 M/5 F). Linear mixed models were used to determine main effects of time. Mean arterial blood pressures are presented as closed triangles (▴), systolic blood pressure is as open circles (○), and diastolic blood pressures as closed circles (●). * versus month 1, P < 0.05. Data are means ± SD.

Figure 2.

Carotid stiffness (A), distensibility (B), compliance (C), and Young’s modulus (D) in young adults with SARS-CoV-2. Month 1: 25 ± 6 days after positive SARS-CoV-2 test, n = 14 (7 M/7 F); month 2: 57 ± 7 days, n = 14 (7 M/7 F); month 3: 87 ± 8 days, n = 12 (7 M/5 F); month 4: 119 ± 13 days, n = 13 (7 M/6 F); month 6: 174 ± 15 days, n = 12 (7 M/5 F). Linear mixed models were used to determine main effects of time. Data are means ± SD.