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This team, which includes Mohsen Agharazii and Catherine Fortier from the Faculty of Medicine at Université Laval and the CHU de Québec - Université Laval Research Center, studied the vascular stiffness of nearly 2100 people across 18 countries.
The sample consisted of three groups of subjects who had contracted COVID-19: the first group had not been hospitalized (most had mild infections), the second had been hospitalized in regular care units (moderate severity infections), and the last had been admitted to intensive care (severe infections). Finally, 391 people who had never had COVID-19 served as a control group.
"To assess vascular stiffness, we measure the speed of the pulse wave propagation in the aorta, the body's main artery, using sensors placed at the neck and thigh," explains Professor Agharazii. "The stiffer the aorta, the faster the wave travels. Since this speed increases with age, we can use it to estimate a person's vascular age."
The research team measured pulse wave velocity in subjects twice, at 6 months and 12 months after a COVID-19 infection. The scientists found that in women, this speed was higher in all three groups who had COVID-19 compared to the control group. The differences were equivalent to 5 years of vascular aging for the groups with mild or moderate infections, and 10 years for the group with severe infections. No differences were observed in men.
How to explain this difference between men and women? "The immune response against infections is generally more robust in women. This may provide resistance against infection, but this immune hyperactivation could lead to more inflammation and more severe damage to blood vessels," suggests Professor Fortier.
The receptors that SARS-CoV-2 binds to in order to infect cells are abundant in the cells of the inner lining of blood vessels. "Even after the infection has cleared, scarring may remain that affects vascular stiffness. This can lead to increased cardiac workload and higher blood pressure that may affect the heart, brain, and kidneys," explains Professor Agharazii.
Twelve months after infection, the average vascular stiffness of women who had COVID-19 had not returned to the level of the control group. "We don't know if the infection-induced vascular stiffness is permanent, but certain lifestyle habits such as regular physical activity, a balanced diet, and taking prescribed medication - particularly for hypertension - can help reduce the associated risks," reminds Professor Fortier.
A significant portion of the population has had at least one episode of COVID-19, which means many people may be affected by this increase in vascular stiffness. "Having had COVID-19 should be taken into account, along with high blood pressure, diabetes, cholesterol levels, or lifestyle habits, when assessing a woman's cardiovascular risk. It's an additional risk factor that must be included in the equation," concludes Professor Agharazii.
The study co-authored by professors Mohsen Agharazii and Catherine Fortier in the European Heart Journal was led by Rosa Maria Bruno from Université Paris Cité.