Arterial Stiffness and Functional Impairment in Post-COVID-19 Syndrome: A Multifactorial Puzzle

The cross-sectional study presented in the manuscript “Arterial Stiffness, Clinical-Functional Outcomes, and Quality of Life in Post-COVID-19 Patients: A Cross-Sectional Study” contributes to our understanding of the persistent sequelae of SARS-CoV-2 infection. The authors demonstrate that individuals in the post-COVID-19 period, compared to healthy controls, have higher pulse wave velocity (PWV) values, the primary marker of arterial stiffness. They also report a higher augmentation index (AIx@75), which does not directly indicate arterial stiffness but is a parameter reflecting pulse wave reflection; this can be influenced by arterial stiffness as well as by other confounding factors. These findings are consistent with global evidence, such as the multicenter CARTESIAN study, which identified early vascular aging in survivors of the disease, with a particularly pronounced impact on women.

An intriguing aspect of the manuscript is the observation that, although PWV is elevated in the post-COVID group, the adjusted analysis suggests that this increase was predominantly driven by age and systolic blood pressure, rather than by the post-COVID-19 condition independently. On the other hand, some studies indicate that the deleterious effect of the virus on markers of arterial stiffness and endothelial function may persist for months after the acute phase has resolved.^,

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