Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study
Rosa Maria Bruno, Smriti Badhwar, Leila Abid, Mohsen Agharazii, Fabio Anastasio, Jeremy Bellien, Otto Burghuber, Luca Faconti, Jan Filipovsky, Lorenzo Ghiadoni, Cristina Giannattasio, Bernhard Hametner, Alun D Hughes, Ana Jeroncic, Ignatios Ikonomidis, Mai Tone Lonnebakken, Alessandro Maloberti, Christopher C Mayer, Maria Lorenza Muiesan, Anna Paini, Andrie Panayiotou, Chloe Park, Chakravarthi Rajkumar, Carlos Ramos Becerra, Bart Spronck, Dimitrios Terentes-Printzios, Yesim Tuncok, Thomas Weber, Pierre Boutouyrie, Cartesian Investigators
Background and Aims Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.
Supplementary data Supplementary data are available at European Heart Journal online.
Declarations
Disclosure of Interest Nothing to declare.
Ethical Approval The CARTESIAN study was planned as a joint analysis of several national studies, using an identical protocol written by the Cartesian Scientific Committee. Approval by local Ethics Committee was obtained in each centre. Additional studies, with ethical clearance complying with the declaration of Helsinki and using similar techniques and protocols, were also included in the final analysis of the CARTESIAN study.
Pre-registered Clinical Trial Number The pre-registered clinical trial number is Clinicaltrials.gov (NCT04558450).
Appendix The CARTESIAN Investigators Austria: (Wels, Klinikum Wels-Grieskirchen, II Interne) Herta Almhofer, Kathen Danninga, Margot Algner, Martin Wernhart, Thomas Weber
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"DOI": "10.1093/eurheartj/ehaf430",
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"abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Background and Aims</jats:title>\n <jats:p>Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>This prospective, multicentric, cohort study, included 34 centres in 16 countries worldwide, in 4 groups of participants—COVID-19-negative controls (ⅰ) and three groups of individuals with recent (6 ± 3 months) exposure to SARS-CoV-2: not hospitalized (ⅱ), hospitalized in general wards (ⅲ), and hospitalized in intensive care units (ⅳ). The main outcome was carotid-femoral pulse wave velocity (PWV), an established biomarker of large artery stiffness.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>2390 individuals (age 50 ± 15 years, 49.2% women) were recruited. After adjustment for confounders, all COVID-19-positive groups showed higher PWV (+0.41, +0.37, and +0.40 m/s for groups 2–4, P &lt; .001, P = .001 and P = .003) vs. controls [PWV 7.53 (7.09; 7.97) m/s adjusted mean (95% CI)]. In sex-stratified analyses, PWV differences were significant in women [PWV (+0.55, +0.60, and +1.09 m/s for groups 2–4, P &lt; .001 for all)], but not in men. Among COVID-19 positive women, persistent symptoms were associated with higher PWV, regardless of disease severity and cardiovascular confounders [adjusted PWV 7.52 (95% CI 7.09; 7.96) vs. 7.13 (95% CI 6.67; 7.59) m/s, P &lt; .001]. A stable or improved PWV after 12 months was found in the COVID+ groups, whereas a progression was observed in the COVID− group.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>COVID-19 is associated with early vascular ageing in the long term, especially in women.</jats:p>\n </jats:sec>",
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