Endothelial dysfunction is one of the most important elements of pathophysiological cascade initiated by SARS-CoV-2 virus (Severe acute respiratory syndrome-related coronavirus 2) that activates systemic inflammation, change of tone and permeability of vascular wall.
OBJECTIVE
To study associations between the endothelial markers level: total nitrate and nitrite ions and endothelin-1 (End-1) in blood and clinical, morphofunctional characteristics of vascular wall stiffness depending on the status of COVID-19 disease (COronaVIrus Disease 2019).
MATERIAL AND METHODS
Cohort of conditionally healthy patients (n=168) aged 18—69 years was examined with evaluation of clinical anthropometric indicators, including vascular wall stiffness (volumetric sphygmometry method), atherosclerosis severity of the brachiocephalic arteries (duplex ultrasound method), vascular endothelium functional activity (Cellermaer’s test). End-1 concentration was measured using ready set, and NOx was determined in deproteinised serum by Griess method with modifications. Detection of antibodies against SARS-CoV-2-S1 RBD in serum was carried out using ready set.
RESULTS
Patients after COVID-19 had direct associations between 12 examined parameters and End-1 and most of these parameters and NOx compared to the group with negative status to disease. Previous COVID-19 was associated with a decrease in diastolic blood pressure (DBP) and ankle-brachial index, as well as with a decrease in levels of End-1 and uric acid in serum while increasing vascular wall stiffness, evaluated using appropriate indices, and confirmed proportion of subjects with positive Cellermaer’s test. The group with previous COVID-19 differed by associations not only between NOx and parameters such as age, body mass index, waist circumference, creatinine level and SCORE index, but also between ratio of NOx/End-1 and parameters such as uric acid, creatinine and glucose.
CONCLUSION
Previous novel coronavirus infection was associated with possible compensatory body responses, that made it possible to deal with disease quite effectively despite the presence of signs of increased vascular wall stiffness in subjects after COVID-19. It is possible, that increased vascular wall stiffness was compensated by decrease in DBP accompanied by a decrease in End-1 level in serum. Creatinine, which level correlated with endothelial dysfunction markers only in the group with positive status, should be separately distinguished. This indicates the effect of disease not only on endothelial function of the vessels, but also on renal function.