The study, led by Professor Rosa Maria Bruno from Université Paris Cité in France, sought to investigate the long-term impact of COVID-19 on vascular health.
To explore these effects, the researchers studied 2,390 individuals from 16 countries between September 2020 and February 2022. Participants were divided into four groups: those never infected with COVID, those who had mild COVID without hospitalisation, those hospitalised in general wards, and those treated in intensive care units. Vascular age — assessed through pulse wave velocity (PWV), a measure of artery stiffness — was measured at six and twelve months post-infection.
The findings revealed that people who had COVID-19, even with mild symptoms, had stiffer arteries than those who were never infected. Women in particular showed more pronounced effects. Mild cases in women led to a pulse wave velocity increase of 0.55 m/s, rising to 1.09 m/s in those admitted to ICU — changes considered clinically significant and equivalent to five years of vascular ageing.
The study also found that vaccinated individuals had less arterial stiffness compared to those who were unvaccinated.
“There are several possible explanations for the vascular effects of Covid. The Covid-19 virus acts on specific receptors in the body, called the angiotensin-converting enzyme 2 receptors, that are present on the lining of the blood vessels. The virus uses these receptors to enter and infect cells. This may result in vascular dysfunction and accelerated vascular ageing. Our body’s inflammation and immune responses, which defend against infections, may be also involved,” Professor Bruno said.
She explained that a stronger immune response in women may explain their increased vascular damage.
Importantly, Bruno emphasized that vascular ageing is reversible with interventions like lifestyle changes, blood pressure and cholesterol control. As experts continue to unravel long COVID's effects, the study underscores the importance of monitoring heart health post-infection.
Reference: 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, the CARTESIAN Investigators , Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study, European Heart Journal, 2025;, ehaf430, https://doi.org/10.1093/eurheartj/ehaf430
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