Cardiovascular and Cerebral Vascular Health in Females with Post-Acute Sequelae of COVID-19 (PASC) 2023 Nandadeva et al

[Andy]

Abstract

Many individuals who had COVID-19 develop detrimental persistent symptoms; a condition known as post-acute sequelae of COVID-19 (PASC). Despite the elevated risk of cardiovascular disease following COVID-19, limited studies have examined vascular function in PASC with equivocal results reported. Moreover, the role of PASC symptom burden on vascular health has not been examined.

We tested the hypothesis that peripheral and cerebral vascular function would be blunted, and central arterial stiffness would be elevated in patients with PASC compared to age-matched controls. Furthermore, we hypothesized that impairments in vascular health would be greater in those with higher PASC symptom burden.

Resting blood pressure (BP; brachial and central), brachial artery flow-mediated dilation (FMD), forearm reactive hyperemia, carotid-femoral pulse wave velocity (PWV), and cerebral vasodilator function were measured in 12 females with PASC and 11 age matched female controls without PASC. The severity of persistent symptoms in those with PASC was reported on a scale of 1-10 (higher score: greater severity).

Brachial BP (e.g., systolic BP, 126±19 vs.109±8 mmHg; P=0.010), central BP (P<0.050) and PWV (7.1±1.2 vs. 6.0±0.8 m/s; P=0.015) were higher in PASC compared to controls. However, FMD, reactive hyperemia, and cerebral vasodilator function were not different between groups (P>0.050 for all). Total symptom burden was not correlated with any measure of cardiovascular health (P>0.050 for all).

Collectively, these findings indicate that BP and central arterial stiffness are elevated in females with PASC, whereas peripheral and cerebral vascular function appear to be unaffected; effects that appear independent of symptom burden.

Paywall, https://journals.physiology.org/doi/abs/10.1152/ajpheart.00018.2023

 

[SNT Gatchaman]

Twelve females who had a previously documented COVID-19 diagnosis (positive SARS-CoV-2 antigen or PCR test) and experienced persistent COVID-19-related symptoms following their diagnosis were recruited from the University of Texas Southwestern Medical Center (Dallas, Texas) COVID Recover Clinic. All patients had a physician diagnosis of PASC. Due to the higher prevalence of PASC in females, only female patients were recruited for the study. Eleven age-matched females without PASC were also recruited from the Dallas-Fort Worth community and studied as the control group. Two of the control participants had a prior diagnosis of COVID-19 (7 and 13 weeks since diagnosis at the time of testing); however, both had mild acute illness and neither had any persistent symptoms beyond 4 weeks from diagnosis. Seven participants in the PASC and six participants in the control group were post-menopausal.

Experiments were performed in a temperature-controlled (20 – 22 °C) dimly lit room. Participants were instrumented with standard lead II electrocardiogram (model Q710, Quinton, Bothell, WA) to continuously measure heart rate (HR) and a pneumobelt (Pneumotrace II 1132, UFI, Morro Bay, CA) to monitor respiratory movements. Subjects rested supine for 20 minutes prior to data collection.

Following this, to assess cerebral vascular function, a 2-MHz transcranial doppler ultrasound probe (Multigon Industries Inc., Yonkers, NY) was held in place over the left temporal window using a headband to measure mean middle cerebral artery blood velocity (MCAvmean). The partial pressure of end-tidal carbon dioxide (PETCO2) and arterial oxygen saturation (SpO2) were measured using a nasal cannula and finger or earlobe pulse oximeter respectively

Collectively, these findings indicate that BP and central arterial stiffness are elevated in females with PASC, whereas peripheral and cerebral vascular function appear to be unaffected

Methods read as if the entire protocol was performed supine. Missed opportunity to assess the peripheral and cerebral blood flow under orthostatic challenge.

Next, a venous blood sample was obtained and sent to a commercial blood processing laboratory (Labcorp) for measurement of fasting blood glucose, lipid panel, and high sensitivity C-reactive protein (hsCRP).

Also a missed opportunity to look at venous oxygen saturation.