Endothelial function, arterial stiffness and heart rate variability of patients with cardiovascular diseases hospitalized due to COVID-19

Background: The novel coronavirus disease (COVID-19) may cause vascular (e.g., endothelial dysfunction, and arterial stiffness), cardiac, autonomic (e.g., heart rate variability [HRV]), and systemic inflammatory response via direct viral attack, hypoxia-induced injury, or immunological dysregulation, especially in those patients with pre-existing cardiovascular diseases (CVD). However, to date, no study has shown prevalence of endo-thelial dysfunction, arterial stiffness and heart rate variability assessed by bedside peripheral arterial tonom-etry in patients with previous CVD hospitalized in the acute phase of COVID-19. Objective: This study aimed to assess the prevalence of endothelial dysfunction, arterial stiffness, and altered HRV in patients with CVD hospitalized due to COVID-19. Methods: This cross-sectional study was conducted from July 2020 to February 2021. Included male and female adult patients aged 40 to 60 years with previous CVD and diagnosed with COVID-19. Anthropometric data, comorbidities, and blood tests were analyzed. Endothelial function, arterial stiffness, and HRV were assessed using peripheral arterial tonometry (PAT), and the statistical significance was set at 5%. Results: Fourteen (51.8%) patients presented endothelial dysfunction (reactive hyperemia index = 1.2 +/- 0.3) and enhancement in the high-frequency component of HRV (p < 0.05). There was a high prevalence of endo-thelial dysfunction, especially in patients with chronic heart failure (10 (71.4%)). Patients with preserved endothelial function showed a high augmentation index normalized to a heart rate of 75 bpm (p < 0.01), sug-gesting arterial stiffness. Conclusion: Patients with CVD hospitalized due to COVID-19 presented endothelial dysfunction assessed using PAT, which could be used as a biomarker for arterial stiffness and altered HRV. The possibility of detect-ing vascular and autonomic changes during phase II of COVID-19 may help to prevent possible long-term complications. (c) 2022 Published by Elsevier Inc.