COVID-19 can cause a patient’s blood vessels to age around 5 years, and this phenomenon is seen most strongly in women, according to findings published yesterday in the European Heart Journal. The study describes how even mild COVID-19 can accelerate cardiac aging.
The study included 2,390 participants from 16 different countries who were recruited from 2020 to 2022. The participants were divided into groups, including those who had never had COVID (controls), those who had COVID but were not hospitalized, those who had the virus and were hospitalized, and those who had the virus and were admitted to an intensive care unit (ICU).
All participants with COVID-19 had the infection within 90 days of study enrollment, and the average age was 50 years. Forty-nine percent of participants were women.
The researchers tested carotid-femoral pulse wave velocity (PWV), or how quickly blood travels from the neck to the legs, to assess the stiffness of blood vessels. Measurements were taken 6 months after initial infections and then again at 12 months. It is known as the CARTESIAN study.
Vaccination tied to protection in women, not men
Overall, all three groups of COVID patients had increases in PWV, indicating that their blood vessels were stiffer following the infection. In sex-stratified analysis, PWV differences were significant in women but not men.
“COVID+ women [those with COVID-19] showed a significantly higher PWV compared with COVID− women [those without] regardless of disease severity,” the authors wrote. COVID-positive women who were treated in the ICU had a doubling in PWV measurement compared with those who were COVID-negative.
The average increase in PWV in women who had mild COVID was 0.55 meters per second, 0.60 in hospitalized women, and 1.09 for women treated in the ICU. The authors said every increase of 0.5 meters per second is clinically relevant and amounts to aging by about 5 years.
In men, vaccination status was not significantly associated with higher PWV readings, but vaccinated women had significantly lower PWV than unvaccinated women (adjusted PWV, 7.35 vs 7.71).
Women’s immune response may explain differences
Additionally, there was no statistical significance in PWV readings among men with or without persistent COVID symptoms. But in women, those with persistent symptoms had high PWV readings, indicative of more vascular aging.
“One of the reasons for the difference between women and men could be differences in the function of the immune system,” said lead study author Rosa Maria Bruno, MD, PhD, from Paris City University, in a press release from the European Society of Cardiology. “Women mount a more rapid and robust immune response, which can protect them from infection. However, this same response can also increase damage to blood vessels after the initial infection”
COVID-19’s vascular legacy is real, measurable, and with a plausible likelihood of sex-specific findings.
In an editorial on the study, Syed Bukhari, MBBS, MD, MHA, from Johns Hopkins University, and his colleagues, said, “The CARTESIAN study delivers an important message to clinicians, researchers, and health policymakers: COVID-19’s vascular legacy is real, measurable, and with a plausible likelihood of sex-specific findings.
“The CARTESIAN study makes the case that COVID-19 has aged our arteries, especially for female adults. The question is whether we can find modifiable targets to prevent this in future surges of infection, and mitigate adverse outcomes in those afflicted with COVID-19-induced vascular ageing.”