Long-term adverse effects of mild COVID-19 disease on arterial stiffness, and systemic and central hemodynamics: a pre-post study

Mario Podrug, Pjero Koren, Edita Dražić Maras, Josip Podrug, Viktor Čulić, Maria Perissiou, Rosa Maria Bruno, Ivana Mudnić, Mladen Boban, Ana Jerončić

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COVID-19-associated vascular disease complications are primarily associated with endothelial dysfunction; however, the consequences of disease on vascular structure and function, particularly in the long term (>7 weeks post-infection), remain unexplored. Individual pre- and post-infection changes in arterial stiffness as well as central and systemic hemodynamic parameters were measured in patients diagnosed with mild COVID-19. As part of in-laboratory observational studies, baseline measurements were taken up to two years before, whereas the post-infection measurements were made 2–3 months after the onset of COVID-19. We used the same measurement protocol throughout the study as well as linear and mixed-effects regression models to analyze the data. Patients (N = 32) were predominantly healthy and young (mean age ± SD: 36.6 ± 12.6). We found that various parameters of arterial stiffness and central hemodynamics—cfPWV, AIx@HR75, and cDBP as well as DBP and MAP—responded to a mild COVID-19 disease. The magnitude of these responses was dependent on the time since the onset of COVID-19 as well as age (pregression_models ≤ 0.013). In fact, mixed-effects models predicted a clinically significant progression of vascular impairment within the period of 2–3 months following infection (change in cfPWV by +1.4 m/s, +15% in AIx@HR75, approximately +8 mmHg in DBP, cDBP, and MAP). The results point toward the existence of a widespread and long-lasting pathological process in the vasculature following mild COVID-19 disease, with heterogeneous individual responses, some of which may be triggered by an autoimmune response to COVID-19.
Original languageEnglish
Article number2123
Number of pages14
JournalJournal of Clinical Medicine
Issue number6
Publication statusPublished - 8 Mar 2023


  • arterial stiffness
  • central hemodynamics
  • COVID-19
  • vascular remodeling
  • long COVID-19 syndrome
  • autoimmune response

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