PROLONGED ENDOTHELIAL DYSFUNCTION IN POST-COVID-19 HYPERTENSIVE PATIENTS

Abstract

Objective: to investigate the endothelial function in hypertensive patients after 1.5 ± 0.4 years after COVID-19 recovery. Design and method: We studied 64 treated hypertensive patients divided into 2 groups: 39 patients recovered from mild to moderate COVID-19 in 2020-2022 years (1st group) and 25 patients were not ill with COVID-19 (2nd group). All patients were vaccinated against COVID-19. The clinical characteristics and laboratory finding measurements were evaluated. Results: There were no significant differences in sex, duration of hypertension, frequency of family history of premature CVD, smoking, alcohol consumption, BMI, and presence of concomitant DM, CAD, stroke/TIA, atrial fibrillation, heart failure, office BP between the 2 groups. The patients in 1st group were younger and had higher GFR than patients in 2nd group (respectively, 57.9 ± 1.0 vs 61.1 ± 1.5 years, P = 0.03 and 83.2 ± 3.4 vs 71.9 ± 3.7 ml/ min/1.73m2, P = 0.03). The levels of anti-spike IgG antibodies by 21.3% were higher in vaccinated patients with prior COVID-19 than in patients without prior COVID-19. Serum IL-10 and TNF- α concentrations did not differ between groups. However, serum levels of asymmetric dimethylarginine (ADMA) (0.64 ± 0.02 vs 0.53 ± 0.02 μmol/l, P = 0.047), CRP (8.6 ± 2.5 vs 4.3 ± 0.6 mg/l, P = 0.049), 24-h albuminuria (28.1 ± 3.8 vs 14.1 ± 2.3 mg/day, P = 0.048) were higher in post-COVID-19 patients than in patients of 2nd group. Conclusions: After 1.5 ± 0.4 years of recovery from COVID-19, the hypertensive patients who received the vaccine were found to have greater activation of systemic inflammation, higher levels of albuminuria, and higher blood ADMA concentrations compared to vaccinated individuals who did not have COVID-19. This fact may indicate a long-lasting dysfunction of the endothelium after suffering from COVID-19 and the absence of such an effect after vaccination without a history of COVID-19.