The indicators of vascular endothelium function in patients with chronic obstructive pulmonary disease after COVID-19

Aim. To analyze indicators of the vascular endothelium function in patients with chronic obstructive pulmonary disease (COPD) depending on the COVID-19 history.

Materials and methods. 98 patients with stable COPD who had COVID-19, regardless of the severity of the infection, were examined 4-8 weeks after discharge from the infectious disease hospital (Group 1). The comparison group included 50 patients with stable COPD without a history of COVID-19 (Group 2). To assess the vascular endothelium function, in all patients the following were determined: endothelin-1 (ET-1, fmol/L), total homocysteine (Hcy, µmol/L), antigen to von Willebrand factor (vWF, fmol/L), C-reactive protein (CRP, mg/L). The following parameters of arterial stiffness (AS) were recorded using sphygmomanometry (Vasera-1000, Japan): pulse wave velocity (PWV, m/s), right/left cardio-ankle vascular index (R/L-CAVI, units), augmentation index on the right shoulder (R-AI, units), augmentation index on the common carotid artery (C-AI, units).

Results. The concentration of biomarkers Hcy, ET-1, vWF in the 1st group was significantly higher than in the 2nd group (p<0.01, p<0.05 and p<0.05, respectively). The studied parameters of AS in patients with COPD were significantly higher than the reference values, regardless of the presence of a COVID-19 history. In patients of the 1st group, the indices R-AI and CAI (p<0.05) were significantly higher than in patients of the 2nd group. Correlation analysis showed relationships between R-CAVI and CRP (r=0.513, p<0.001) and CRP and ET-1 (r=0.485, p<0.01).

Conclusion. In patients with COPD, the past COVID-19 leads to more significant shifts in the functional activity of the vascular endothelium than in isolated COPD of a stable course and is associated with active systemic inflammation.

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