Abstract
Background: Cardiovascular diseases account for one-third of deaths worldwide. Arterial stiffness is considered as useful predictor of cardiovascular events as measured by pulse wave velocity. Hypertension promotes collagen production causing increase in vascular thickness and arterial stiffness. Diabetes is a potential risk factor for arterial stiffness causing imbalance between production and degradation of collagen and elastic fibres. Oxidative stress in obesity leads to endothelial dysfunction and increases arterial stiffness. Hyperinflammation in COVID-19 is proposed to stimulate inflammatory cells that produce collagenases and elastases, which disrupt physiology causing increased arterial stiffness. Hence, in this study we attempt to investigate to which extent COVID-19 increases arterial stiffness especially in individuals with conditions including hypertension, diabetes and obesity. Objectives: This study aimed to measure pulse wave velocity (PWV) in post-COVID 19 patients with diabetes, hypertension and obesity and compare it with individuals with comorbidities without COVID. Mthods:The study population included 184 individuals in the age group of 30-50 years who were divided into four groups as follows: group I comprised subjects with diabetes (n= 64), group II patients with hypertension (n=40), group III subjects with obesity (n=50) and group IV controls (n=30). Groups I, II and III were further divided into two subgroups each, depending on the presence or absence of COVID-19. Arterial stiffness was assessed in all study participants. Results: The results of the present study show a strong correlation between COVID-19 and increased arterial stiffness, particularly in individuals with comorbidities such as diabetes, obesity and hypertension. The mean brachial ankle PWV (baPWV), carotid-femoral PWV (CFPWV) and ankle arterial stiffness index (ASI) was significantly higher among subjects with a history of COVID-19 with hypertension, (p <0.001), followed by high values in obese subjects with COVID-19 and diabetes subjects with COVID-19 when compared to controls. Conclusion:As COVID-19 is associated with increased arterial stiffness, particularly in individuals with comorbidities, undoubtedly it has long-term effects on vascular ageing and physiology. Hypertension was found to be the riskiest factor for increased vascular stiffness in COVID-19 patients.