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.