The COSEVAST Study: Unravelling the role of Arterial Stiffness in COVID-19 Disease severity

Background Based on the detailed review of available research and case studies reported in reputed international journals, it can be concluded that endothelial damage (En-dotheliitis) both in small and large arteries may be an important factor of morbidity and mortality in COVID-19 patients. Arterial stiffness due to Endothelial Dysfunction has been established as an independent and specific marker of various chronic cardiovascular diseases. Objective Our objective was to examine functional impairment of the arteries in COVID-19 disease and establish the non-invasive measurement of Arterial Stiffness as an independent marker of disease severity. Methods We recorded the Arterial Stiffness of 23 Mild, 21 Moderate and 20 Severe COVID-19 patients grouped on latest NIH severity criteria. We observed Arterial Stiffness of COVID-19 patients with standard parameters like non-invasive Carotid-Femoral Pulse Wave velocity (cfPWV), Age-Normalized increase in cfPWV (ANI_cfPWV). Results Moderate and Severe COVID-19 patients have extremely elevated arterial stiffness than Mild patients. In Mild patients, cfPWV (829.1 ± 139.2 cm/s) was extremely significantly lower than both Moderate (1067 ± 152.5 cm/s, P< 0.0001) and Severe (1416 ± 253.9 cm/s, P < 0.0001) patients. ANI_cfPWV in Moderate and Severe patients was significantly higher than Mild patients. (Mild: 101.2 ± 126.1 cm/s; Moderate: 279 ± 114.4 cm/s; Severe: 580.1 ± 216.4 cm/s; intergroup P <0.0001). Conclusion: Our findings strongly suggest that arterial stiffness can be an independent and accurate marker for objective risk stratification and therapeutic alleviation of the acute cardiovascular complications like MODS in COVID-19.