Structural and functional vascular changes and exercise tolerance at the long-term follow-up after COVID‑19

Background. Endothelial dysfunction is considered one of the possible pathophysiologic mechanisms of decreased exercise tolerance in patients after COVID‑19.
Objective. To evaluate the structural and functional vascular changes and exercise tolerance in patients at the long-term follow-up after hospitalization for COVID‑19.
Design and methods. Patients older than 18 years of age from the epidemiological ESSE-RF study were examined: COVID‑19 group (n = 31) — patients hospitalized due to COVID‑19; control group (n = 31) — patients not hospitalized due to COVID‑19. Endothelial state was assessed by levels of von Willebrand factor (vWF), interleukin 6 (IL‑6), and trimethylamine-N-oxide (TMAO); arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) and by cardio-ankle vascular index (CAVI); exercise tolerance was evaluated by cardiopulmonary exercise testing (CPET).
Results. The patients were examined at 570 ± 179 days after hospitalization for COVID‑19. There were no differences in vascular parameters between the COVID‑19 group and the control group (p > 0,05): vWF — 2,2 (0,5; 2,7) vs. 2,3 (1,0; 2,9) U/mL, IL‑6–1,5 (1,0; 3,1) vs. 1,6 (1,0; 3,5) pg/mL, TMAO — 1023,9 (712,7; 1284,7) vs. 896,9 (731,0; 1061,1) pg/mL, cfPWV — 8,4 (7,1; 9,5) vs. 8,2±1,1 m/s, CAVI — 8,0 ± 1,1 vs. 8,2 ± 1,1; as for the results of the CPET: VO2peak — 86,0 (81,0; 92,7) % predicted vs. 86,0 (81,0; 91,5) % predicted, VE/VCO2peak — 28,7 ± 4,5 vs. 27,6 ± 4,8, breathing reserve — 54,7 ± 10,0 % vs. 58,3 ± 8,1 %.
Conclusion. Patients in the long-term period after hospitalization for COVID‑19 show no structural and functional changes or exercise tolerance issues in CPET compared with patients who were not hospitalized for COVID‑19.

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