EVALUATION OF CLINICAL AND METABOLIC FACTORS ASSOCIATED WITH INTIMA-MEDIA THICKNESS AS A CARDIOVASCULAR RISK MARKER IN PATIENTS WITH AND WITHOUT A HISTORY OF SYMPTOMATIC COVID-19

Objective: To assess the clinical and metabolic determinants of intima-media thickness (IMT) as a cardiovascular risk marker in patients with a history of symptomatic COVID-19. Design and method: The clinical outcomes of 92 patients hospitalised for various reasons with a median age of 70 years were analysed. For each patient (COVID-19: n=47, control: n=45), anthropometric, biochemical, medical and medication data were collected. IMT of the common carotid artery (CCA) was measured by ultrasound according to the recommendations of the Polish Society of Vascular Surgery. Correlations with age, lipid profiles and medications were analysed. Results: A statistical analysis indicated a balanced representation of COVID-19 patients and controls. Age significantly correlated with IMT in both groups (COVID-19: Rho=0.49; control: Rho=0.58; p<0.001). In the COVID-19 group, the triglyceride/ high-density lipoprotein (TG/HDL) ratio (Rho = 0.34, 95% CI: 0.04 – 0.58, p = 0.022) showed statistically significant positive correlation with IMT, in contrast to the control group (Rho = 0.12, 95% CI: -0.20 – 0.41, p = 0.453). Moreover, other lipid parameters including HDL cholesterol (Rho = -0.33, 95% CI: -0.57 – -0.03, p = 0.029), low-density lipoprotein (LDL) cholesterol (Rho = -0.31, 95% CI: -0.56 – -0.01, p = 0.039) and total cholesterol (Rho = -0.30, 95% CI: -0.55 – 0.00, p = 0.044) were inversely correlated with IMT in COVID-19 patients. The use of acetylsalicylic acid and angiotensin converting enzyme (ACE) inhibitors correlated with higher IMT in both groups. Conclusions: Older age is a key factor contributing to increased vascular thickness, regardless of COVID-19. Maintaining high HDL levels and monitoring the TG/HDL ratio may constitute key strategies to reduce cardiovascular risk in patients recovering from symptomatic COVID-19. The results highlight the paramount significance of HDL and the TG/HDL ratio among all lipid markers. Negative correlations for LDL and total cholesterol require further explanation and confirmation. The results underscore the need for cardiovascular monitoring and targeted prevention strategies, such as lipid management and metabolic risk reduction, in post-COVID-19 patients. Further research is crucial to clarify the long-term vascular effects of COVID-19 and refine risk-reduction strategies.