Hospitalization for COVID-19 was associated with significantly higher carotid intima-media thickness at 6 months compared to negative controls (0.745 mm vs 0.66 mm), particularly in men.
Cohort (n=688)
Yes
Does COVID-19 infection severity increase sub-clinical atherosclerosis and arterial remodelling in patients 6 months post-infection?
Hospitalization for COVID-19 is associated with worse vascular remodeling at 6 months, particularly in men, suggesting a potential increased risk of cardiovascular disease.
Absolute Event Rate: 0.745% vs 0.66%
Objective: COVID-19 can lead to a persistent low-grade inflammatory that could be potentially associated with arterial remodelling and potential atherosclerotic changes, resulting in an increased risk of cardiovascular disease. The aim of this study was to evaluate sub-clinical atherosclerosis and arterial remodelling in patients post COVID-19 infection. Design and method: This is a prospective, multi-centric, cohort, including 15 countries worldwide. Participants were recruited 6 months after COVID19 infection. Carotid intima-media thickness (IMT) was evaluated by processing longitudinal B-mode ultrasound scans (>/=7.5 MHz linear array transducer). Left and right carotid arteries were imaged 1-2 cm proximal to the carotid bifurcation and the mean of the two values was used for the analysis. Participants were classified into 4 groups-COVID-19 negative control (NC) (n = 107), and three COVID-19 positive groups classified by severity: not hospitalized (or hospitalization for less than 24 hours) (NHP) (n = 270), hospitalized patients in medical unit (HP) (n = 246), and patients requiring ICU/resuscitation care (ICU) (n = 65). Results: Patients in the HP and ICU groups were significantly older compared to controls NC 44(28-58), NHP 42(31-52), HP 57(49-66), ICU 58(51-66) years. Both unadjusted/adjusted hierarchical linear models (for age, sex, BMI, smoking status, established CVD, diabetes, and hypertension) showed a significantly higher IMT in HP compared with NC (adjusted mean (95% CI): 0.745 0.69–0.80 mm vs 0.66 (0.60–0.72) mm). In addition, a significant group × sex interaction was observed, with sex-specific analyses showing an approximately twofold greater increase in IMT in HP men compared with HP women. Wall to lumen ratio was also higher in HP (0.33(0.30;0.37)) vs NC (0.26(0.22;0.30)), with a significant group × sex interaction. After adjusting for confounders, wall lumen ratio in HP compared to NC was twice as higher in men in comparison to women. Conclusions: Patients hospitalised for more than 24 hours during COVID 19 show impaired vascular characteristics, with a greater disease-associated vascular remodelling in men compared to women. This could be potentially due to a combined effect of pre-existing vascular damage that predispose them to severe COVID-19 and accelerated vascular remodelling due to persistent chronic inflammation.
Badhwar et al. (Fri,) conducted a cohort in Post COVID-19 infection (n=688). Hospitalization for COVID-19 vs. COVID-19 negative control was evaluated on Carotid intima-media thickness (IMT). Hospitalization for COVID-19 was associated with significantly higher carotid intima-media thickness at 6 months compared to negative controls (0.745 mm vs 0.66 mm), particularly in men.