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. Methods: 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. Results: 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 < .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 < .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 < .001]. A stable or improved PWV after 12 months was found in the COVID+ groups, whereas a progression was observed in the COVID- group. Conclusions: COVID-19 is associated with early vascular ageing in the long term, especially in women.
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; Investigators, Cartesian; Almhofer, Herta; Danninga, Kathen; Algner, Margot; Wernhart, Martin; Weber, Thomas; Hametner, Bernhard; C Mayer, Christopher; Burghuber, Otto; Azizzadeh, Mohammad; Breyer, Marie-Kathrin; Bortolotto, Luiz; Fernando Vilela-Martin, Jose; Toshiro Passos Okawa, Rogério; Lyrio Bermudes Okawa, Jaqueline; Kunz Sebba Barroso, Weimar; Gomes Ciolac, Emmanuel; Teixeira Do Amaral, Vanessa; Fernandez, Bianca; Goupil, Rémi; Agharazii, Mohsen; Fortier, Catherine; G Panayiotou, Andrie; Photiou, Galatia; Filipovský, Jan; Mayer, Otto; Seidlerová, Jitka; Pazdiora, Petr; Hirmerová, Jana; Šustková, Lucie; Bílková, Simona; Gelžinský, Július; Kordíková, Veronika; Mareš, Štěpán; Cífková, Renata; Wohlfahrt, Peter; Kavalírová, Jana; Maria Bruno, Rosa; Boutouyrie, Pierre; Khettab, Hakim; Justin, Junior; Moriconi, Diego; Fabbri, Saverio; Sebastien Hulot, Jean; Fayol, Antoine; Courbebaisse, Marie; Parfait, Beatrice; Lebeaux, David; Friedlander, Gérard; Bellien, Jeremy; Joannides, Robinson; Iacob, Michele; Leroi, Anne-Marie; Benetos, Athanase; Georgiopoulos, Ioannis; Terentes-Printzios, Dimitrios; Christopoulou, Georgia; Tsioufis, Konstantinos; Gardikioti, Vasiliki; Vlachopoulos, Charalambos; Ikonomidis, Ignatios; Lambadiari, Vaia; Kountouri, Alkaternini; Katogiannis, Konstantinos; Jerončić, Ana; Podrug, Mario; Pavičić-Ivelja, Mirela; Koren, Pjero; Lorenza Muiesan, Maria; Paini, Anna; Salvetti, Massimo; Cacciatore, Marco; Pucci, Giacomo; Anastasio, Fabio; Scarnecchia, Elisa; Giannattasio, Cristina; Alessandro, Maloberti; Algeri, Michela; Moreo, Antonella; Tognola, Chiara; Grillo, Andrea; Fabris, Bruno; Bernardi, Stella; Rovina, Matteo; Di Pierro, Giuliano; Ghiadoni, Lorenzo; Armenia, Sabina; Bianchini, Elisabetta; Zanoli, Luca; Castellino, Pietro; Montineri, Arturo; Sciuto, Alice; Grassi, Davide; Badariene, Jolita; Ryliskyte, Ligita; Laucyte-Cibulskiene, Agne; Jancoriene, Ligita; Ryliskiene, Kristina; Juceviciene, Agne; Kovaite, Milda; Balkeviciene, Laura; G Ramos-Becerra, Carlos; Alanis-Sánchez, Guillermos; Martinez-Ayala, Pedro; G Cardona-Muñóz, Ernesto; Cardona-Muller, David; Tone Lonnebakken, Mai; Annette Berge, Caroline; Bohn, Lucimere; Oliveira, José; Alves, Emilia; Pedro Costa, Simao; Pereira, Telmo; Caseiro, Armando; Lira, Fábio; Rosa Bernal López, Maria; Isabel Ruiz Moreno, María; Gómez Huelgas, Ricardo; Lopez Sampalo, Almudena; Sanz Canovas, Jaime; Antonio Vargas Cancela, Victor; Cobos Palacios, Lidia; José Mancebo Sevilla, Juan; Nazlı Zeka, Arzu; Özpelit, Ebru; İncir, Canet; M Barış, Mustafa; Tunçok, Yeşim; Canturk, Ali; Can Cimilli, Hasan; Abid, Leila; Abdessalem, Salem; Charfeddine, Selma; Bahloul, Amine; Hammami, Rania; Walha, Mahdi; Hughes, Alun; Park, Chloe; Jamieson, Alexandra; J Chowienczyk, Philip; Faconti, Luca; Farukh, Bushra; Akhtar, Riaz; Shantsila, Alena; Lip, Gregory; N Gurovich, Alvaro; Gomez, Manuel; Stoner, Lee; Meyer, Michelle; Hanson, Erik; Zieff, Gabriel; Pagan Lassalle, Patricia; Bates, Lauren. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 46:39(2025), pp. 3905-3918. [10.1093/eurheartj/ehaf430]
Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study
Andrea GrilloMembro del Collaboration Group
;Bruno FabrisMembro del Collaboration Group
;Stella BernardiMembro del Collaboration Group
;Matteo RovinaMembro del Collaboration Group
;Giuliano Di PierroMembro del Collaboration Group
;Pietro CastellinoMembro del Collaboration Group
;
2025-01-01
Abstract
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. Methods: 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. Results: 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 < .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 < .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 < .001]. A stable or improved PWV after 12 months was found in the COVID+ groups, whereas a progression was observed in the COVID- group. Conclusions: COVID-19 is associated with early vascular ageing in the long term, especially in women.| File | Dimensione | Formato | |
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