Aortic stiffness and indexes of disease severity in subjects with previous COVID-19 penumonia:a follow-up study

OBJECTIVE: Up to date the possibility of a vascular damage due to COVID-19 pneumonia is a not clarified. We searched for relationships between the carotid-femoral pulse wave velocity (cfPWV) and clinical and biochemical markers of severity of the infectious disease, after hospital discharge, in a group of patients who had been admitted in care units. DESIGN AND METHOD: In 69 subjects (age 58 ± 13 years, 36 males), previously admitted in hospital because of COVID-19 pneumonia, we evaluated at the time of hospital admission anthropometric parameters, blood pressure, history of arterial hypertension or other diseases, drugs, smoking and alcohol habit, physical activity level, and indexes of infectious disease severity, such as the SIMEU score, need for invasive oxygen delivery, PaO2, PaCo2, inflammatory markers such as white blood cells count, levels of proadrenomedulline (proADM), reactive C protein, procalcitonin, IL- 6, glomerular filtration rate (GFR), troponin, mioglobin, B natriuretic peptide. After an average 2 months follow-up the cfPWV was measured. RESULTS: At univariate analysis the cfPWV was significantly and positively related to age (r = 0.454, P < 0.001), body mass index (r = 0.436, P = 0.016), waist circumference (r = 0.345, P = 0.004), levels of plasma glucose (r = 0.430, P = 0.001), proADM (r = 0.456, P = 0.006), IL-6 (r = 0.280, P = 0.037), mioglobin (r = 0.443, P = 0.001) and inversely related to GFR (r = -0.289, P = 0.023). The cfPWV was higher in diabetics subjects than in non-diabetics (P = 0.011), and in patients who had needed invasive oxygen support (P = 0.044). There was no difference in cfPWV in patients with or without history of arterial hypertension or with different blood pressure levels at admission. At multivariate analysis the cfPWV was independently associated with invasive oxygen support (B = 0.168, P = 0.012), body mass index (B = 0.180, P = 0.001), waist circumference (B = 0.162, P = 0.002), GFR (B = 0.078, P = 0.008), and proADM levels (B = 0.161, P = 0.003). CONCLUSIONS: In patients who recovered from COVID-19 pneumonia the aortic stiffness is associated with severity of disease and levels of proADM, but not with history of hypertension. Patients with more higher proADM levels in acute phase of the infectious disease could need a longer follow-up evaluation of the CFPWV after the recovering from disease to search for long time vascular damage.