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Article

Impaired Endothelial Function in Convalescent Phase of COVID-19: A 3 Month Follow Up Observational Prospective Study

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Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Department of Emergency Medicine, Internal and Sub-Intensive Medicine, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60166 Ancona, Italy
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Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Department of Emergency Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Department of Ophthalmology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Department of Experimental and Clinical Medicine, Clinica Medica, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60166 Ancona, Italy
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Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Università Cattolica del Sacro Cuore, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Membership of the Group Name is provided in the Acknowledgments.
Academic Editors: Alexandros Briasoulis, Kimon Stamatelopoulos and Georgios Georgiopoulos
J. Clin. Med. 2022, 11(7), 1774; https://doi.org/10.3390/jcm11071774
Received: 25 February 2022 / Revised: 18 March 2022 / Accepted: 20 March 2022 / Published: 23 March 2022
Background: Endothelial dysfunction has a role in acute COVID-19, contributing to systemic inflammatory syndrome, acute respiratory distress syndrome, and vascular events. Evidence regarding COVID-19 middle- and long-term consequences on endothelium are still lacking. Our study aimed to evaluate if COVID-19 severity could significantly affect the endothelial function after three months from the acute phase. Methods: We assessed endothelial function in outpatients with previous COVID-19 three months after negative SARS-CoV-2 molecular test by measuring flow-mediated dilation (FMD) in patients categorized according to a four-variable COVID-19 severity scale (“home care”; “hospital, no oxygen”; “hospital, oxygen”; “hospital requiring high-flow nasal canula, non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation”). FMD difference among COVID-19 severity categories was assessed with analysis of variance; we further clarified the relationship between FMD and previous COVID-19 severity with multivariate logistic models. Results: Among 658 consecutive COVID-19 subjects, we observed a significant linear trend of FMD reduction with the increase of the COVID-19 category (p < 0.0001). The presence of endothelial dysfunction was more frequent among hospitalized patients (78.3%) with respect to home-care patients (21.7%; p < 0.0001). COVID-19 severity was associated with increased endothelial dysfunction risk (OR: 1.354; 95% CI: 1.06–1.71; p = 0.011) at multivariate binary logistic analysis. FMD showed a significant direct correlation with PaO2 (p = 0.004), P/F ratio (p = 0.004), FEV1 (p = 0.008), and 6MWT (p = 0.0001). Conclusions: Hospitalized COVID-19 subjects showed an impaired endothelial function three months after the acute phase that correlated with pulmonary function impairment. Further studies are needed to evaluate if these subjects are at higher risk of developing pulmonary disease or future cardiovascular events. View Full-Text
Keywords: endothelial dysfunction; flow-mediated dilation; COVID-19; post-acute COVID-19 syndrome endothelial dysfunction; flow-mediated dilation; COVID-19; post-acute COVID-19 syndrome
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MDPI and ACS Style

Santoro, L.; Falsetti, L.; Zaccone, V.; Nesci, A.; Tosato, M.; Giupponi, B.; Savastano, M.C.; Moroncini, G.; Gasbarrini, A.; Landi, F.; Santoliquido, A.; on behalf of Gemelli against COVID-19 Post-Acute Care Study Group. Impaired Endothelial Function in Convalescent Phase of COVID-19: A 3 Month Follow Up Observational Prospective Study. J. Clin. Med. 2022, 11, 1774. https://doi.org/10.3390/jcm11071774

AMA Style

Santoro L, Falsetti L, Zaccone V, Nesci A, Tosato M, Giupponi B, Savastano MC, Moroncini G, Gasbarrini A, Landi F, Santoliquido A, on behalf of Gemelli against COVID-19 Post-Acute Care Study Group. Impaired Endothelial Function in Convalescent Phase of COVID-19: A 3 Month Follow Up Observational Prospective Study. Journal of Clinical Medicine. 2022; 11(7):1774. https://doi.org/10.3390/jcm11071774

Chicago/Turabian Style

Santoro, Luca, Lorenzo Falsetti, Vincenzo Zaccone, Antonio Nesci, Matteo Tosato, Bianca Giupponi, Maria Cristina Savastano, Gianluca Moroncini, Antonio Gasbarrini, Francesco Landi, Angelo Santoliquido, and on behalf of Gemelli against COVID-19 Post-Acute Care Study Group. 2022. "Impaired Endothelial Function in Convalescent Phase of COVID-19: A 3 Month Follow Up Observational Prospective Study" Journal of Clinical Medicine 11, no. 7: 1774. https://doi.org/10.3390/jcm11071774

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