Michael Coston
Editor, Senior Moderator
EHJ: Accelerated Vascular Ageing After COVID-19 Infection: The CARTESIAN Study
#18,448
According to the CDC latest COVID Data Tracker update (see above), we are seeing another late summer uptick in COVID Cases across the nation. While still small compared to previous waves, with declining immunity and a decreased uptake of COVID vaccines, millions of people are at risk of infection.
And as we've seen, reinfections - even mild ones - have been linked to `Long COVID' and other chronic illnesses (see Preprint: Incidence of Long COVID Following Reinfection with COVID-19).
Very early on (spring, 2020) it became apparent that COVID-19 infection was a high morbidity - (relatively) low mortality infection; several times deadlier than than seasonal flu, but still with a 98%-99% survival rate.
While obviously welcomed news, it was tempered by worrying reports of long hospitalizations, and slow recoveries by many COVID-19 patients, along with many anecdotal reports linking COVID infection to heart attacks, strokes, and other vascular events.
In the first 6 months of the pandemic we saw reports on:
EID Journal: Pulmonary Embolism and Increased Levels of d-Dimer in COVID-19 Patients
EID Journal: Two Reports On Thrombotic Events In COVID-19 Patients
Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young
JAMA Neurology: Elevated Risk of Ischemic Stroke With COVID-19
JAMA: Two Studies Linking SARS-CoV-2 Infection To Cardiac Injury
By 2021 it was increasingly apparent that Post-COVID sequelae may include cardiovascular, renal, pulmonary, neurological, and endocrine disorders (see AHA: COVID-19 May Trigger New-Onset High Blood Pressure).
Hypertension - Credit CDC
Some cardiologists have warned that the impact of COVID-19 on cardiovascular health may not be fully appreciated for years to come (see Coronavirus Disease 2019 (COVID-19) and the Heart—Is Heart Failure the Next Chapter? by Clyde W. Yancy, MD, MSc1,; Gregg C. Fonarow, MD).
Since then, we've seen a long procession of studies showing the long-term impact of COVID appears far from trivial. A few of many include:
JAMA: Additional Evidence Of A Post-COVID/Diabetes Link
Nature: Long-term Cardiovascular Outcomes of COVID-19
The Lancet: Neurological and Psychiatric Risk Trajectories After SARS-CoV-2 Infection
MMWR: Post–COVID-19 Symptoms and Conditions Among Children and Adolescents
This week we've another study, published in the European Heart Journal, that significant `vascular ageing' - particularly in women - following COVID infection.
Due to its length, I've just posted the Abstract, and a brief snippet, followed by a link (and excerpts) to a press release. I'll have more after the break.
Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study
Rosa Maria Bruno , Smriti Badhwar , Leila Abid , Mohsen Agharazii , Fabio Anastasio , Jeremy Bellien , Otto Burghuber , Luca Faconti , Jan Filipovsky , Lorenzo Ghiadoni ... Show more
European Heart Journal, ehaf430, https://doi.org/10.1093/eurheartj/ehaf430
Published: 17 August 2025 Article history
PDF
Background and Aims
Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.
Methods
This prospective, multicentric, cohort study, included 34 centres in 16 countries worldwide, in 4 groups of participants—COVID-19-negative controls (ⅰ) and three groups of individuals with recent (6 ± 3 months) exposure to SARS-CoV-2: not hospitalized (ⅱ), hospitalized in general wards (ⅲ), and hospitalized in intensive care units (ⅳ). The main outcome was carotid-femoral pulse wave velocity (PWV), an established biomarker of large artery stiffness.
Results
2390 individuals (age 50 ± 15 years, 49.2% women) were recruited. After adjustment for confounders, all COVID-19-positive groups showed higher PWV (+0.41, +0.37, and +0.40 m/s for groups 2–4, P < .001, P = .001 and P = .003) vs. controls [PWV 7.53 (7.09; 7.97) m/s adjusted mean (95% CI)]. In sex-stratified analyses, PWV differences were significant in women [PWV (+0.55, +0.60, and +1.09 m/s for groups 2–4, P < .001 for all)], but not in men.
(SNIP)
In conclusion, despite the acknowledged limitations intrinsic to the design of the study, our data indicate that COVID-19 infection is associated with mid-term and long-term accelerated vascular ageing, especially in women.
Further studies are needed to confirm these findings with pre-post studies and to elucidate the effect of vaccination, as well as to demonstrate whether these preclinical alterations are associated with clinical CV events; whether newer SARS-CoV-2 variants are able to induce accelerated vascular ageing to the same extent, and whether reinfections55 are associated with worse arterial stiffness.
(Continue . . . )
Excerpt from the accompanying press release:
Covid infection ages blood vessels, especially in women
18 Aug 2025
Topic(s): Risk Factors and Prevention
A Covid infection, particularly in women, may lead to blood vessels aging around five years, according to research published in the European Heart Journal [1] today.
Blood vessels gradually become stiffer with age, but the new study suggests that Covid could accelerate this process. Researchers say this is important since people with stiffer blood vessels face a higher risk of cardiovascular disease, including stroke and heart attack.
The study was led by Professor Rosa Maria Bruno from Université Paris Cité, France. She said: “Since the pandemic, we have learned that many people who have had Covid are left with symptoms that can last for months or even years. However, we are still learning what’s happening in the body to create these symptoms.
“We know that Covid can directly affect blood vessels. We believe that this may result in what we call early vascular ageing, meaning that your blood vessels are older than your chronological age and you are more susceptible to heart disease. If that is happening, we need to identify who is at risk at an early stage to prevent heart attacks and strokes.”
The study included 2,390 people from 16 different countries (Austria, Australia, Brazil, Canada, Cyprus, France, Greece, Italy, Mexico, Norway, Turkey, UK and US) who were recruited between September 2020 to February 2022. They were categorised according to whether they had never had Covid, had recent Covid but were not hospitalised, hospitalised for Covid on a general ward or hospitalised for Covid in an intensive care unit.
Researchers assessed each person’s vascular age with a device that measures how quickly a wave of blood pressure travels between the carotid artery (in the neck) and femoral arteries (in the legs), a measure called carotid-femoral pulse wave velocity (PWV). The higher this measurement, the stiffer the blood vessels and the higher the vascular age of a person. Measurements were taken six months after Covid infection and again after 12 months.
(SNIP)
“The CARTESIAN study makes the case that COVID-19 has aged our arteries, especially for female adults. The question is whether we can find modifiable targets to prevent this in future surges of infection, and mitigate adverse outcomes in those afflicted with COVID-19-induced vascular ageing.”
ENDS
Most people are familiar with the more obvious signs of `Long COVID' (see CDC list below):
But there may be more insidious health impacts that may not fully manifest for years (e.g. Hypertension, Cardiac problems, Diabetes, Neurodegenerative diseases like `Parkinson's', etc.), or only after repeated infections.
While there are proven ways to reduce the risk of reinfection (COVID vaccines, wearing face mask in public, avoiding indoor crowds, etc.), society - in an attempt to return to `normal' - has trivialized the COVID infection to the point that few now bother.
While many maintain that `what doesn't kill you makes you stronger', what we are learning about the many impacts of `Long COVID' makes a pretty good argument to the contrary.
https://afludiary.blogspot.com/2025/08/ehj-accelerated-vascular-ageing-after.html
#18,448
According to the CDC latest COVID Data Tracker update (see above), we are seeing another late summer uptick in COVID Cases across the nation. While still small compared to previous waves, with declining immunity and a decreased uptake of COVID vaccines, millions of people are at risk of infection.
And as we've seen, reinfections - even mild ones - have been linked to `Long COVID' and other chronic illnesses (see Preprint: Incidence of Long COVID Following Reinfection with COVID-19).
Very early on (spring, 2020) it became apparent that COVID-19 infection was a high morbidity - (relatively) low mortality infection; several times deadlier than than seasonal flu, but still with a 98%-99% survival rate.
While obviously welcomed news, it was tempered by worrying reports of long hospitalizations, and slow recoveries by many COVID-19 patients, along with many anecdotal reports linking COVID infection to heart attacks, strokes, and other vascular events.
In the first 6 months of the pandemic we saw reports on:
EID Journal: Pulmonary Embolism and Increased Levels of d-Dimer in COVID-19 Patients
EID Journal: Two Reports On Thrombotic Events In COVID-19 Patients
Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young
JAMA Neurology: Elevated Risk of Ischemic Stroke With COVID-19
JAMA: Two Studies Linking SARS-CoV-2 Infection To Cardiac Injury
By 2021 it was increasingly apparent that Post-COVID sequelae may include cardiovascular, renal, pulmonary, neurological, and endocrine disorders (see AHA: COVID-19 May Trigger New-Onset High Blood Pressure).
Hypertension - Credit CDC
Some cardiologists have warned that the impact of COVID-19 on cardiovascular health may not be fully appreciated for years to come (see Coronavirus Disease 2019 (COVID-19) and the Heart—Is Heart Failure the Next Chapter? by Clyde W. Yancy, MD, MSc1,; Gregg C. Fonarow, MD).
Since then, we've seen a long procession of studies showing the long-term impact of COVID appears far from trivial. A few of many include:
JAMA: Additional Evidence Of A Post-COVID/Diabetes Link
Nature: Long-term Cardiovascular Outcomes of COVID-19
The Lancet: Neurological and Psychiatric Risk Trajectories After SARS-CoV-2 Infection
MMWR: Post–COVID-19 Symptoms and Conditions Among Children and Adolescents
This week we've another study, published in the European Heart Journal, that significant `vascular ageing' - particularly in women - following COVID infection.
Due to its length, I've just posted the Abstract, and a brief snippet, followed by a link (and excerpts) to a press release. I'll have more after the break.
Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study
Rosa Maria Bruno , Smriti Badhwar , Leila Abid , Mohsen Agharazii , Fabio Anastasio , Jeremy Bellien , Otto Burghuber , Luca Faconti , Jan Filipovsky , Lorenzo Ghiadoni ... Show more
European Heart Journal, ehaf430, https://doi.org/10.1093/eurheartj/ehaf430
Published: 17 August 2025 Article history
Background and Aims
Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.
Methods
This prospective, multicentric, cohort study, included 34 centres in 16 countries worldwide, in 4 groups of participants—COVID-19-negative controls (ⅰ) and three groups of individuals with recent (6 ± 3 months) exposure to SARS-CoV-2: not hospitalized (ⅱ), hospitalized in general wards (ⅲ), and hospitalized in intensive care units (ⅳ). The main outcome was carotid-femoral pulse wave velocity (PWV), an established biomarker of large artery stiffness.
Results
2390 individuals (age 50 ± 15 years, 49.2% women) were recruited. After adjustment for confounders, all COVID-19-positive groups showed higher PWV (+0.41, +0.37, and +0.40 m/s for groups 2–4, P < .001, P = .001 and P = .003) vs. controls [PWV 7.53 (7.09; 7.97) m/s adjusted mean (95% CI)]. In sex-stratified analyses, PWV differences were significant in women [PWV (+0.55, +0.60, and +1.09 m/s for groups 2–4, P < .001 for all)], but not in men.
Among COVID-19 positive women, persistent symptoms were associated with higher PWV, regardless of disease severity and cardiovascular confounders [adjusted PWV 7.52 (95% CI 7.09; 7.96) vs. 7.13 (95% CI 6.67; 7.59) m/s, P < .001]. A stable or improved PWV after 12 months was found in the COVID+ groups, whereas a progression was observed in the COVID− group.
Conclusions
COVID-19 is associated with early vascular ageing in the long term, especially in women.
Conclusions
COVID-19 is associated with early vascular ageing in the long term, especially in women.
(SNIP)
Conclusions
In conclusion, despite the acknowledged limitations intrinsic to the design of the study, our data indicate that COVID-19 infection is associated with mid-term and long-term accelerated vascular ageing, especially in women.
Further studies are needed to confirm these findings with pre-post studies and to elucidate the effect of vaccination, as well as to demonstrate whether these preclinical alterations are associated with clinical CV events; whether newer SARS-CoV-2 variants are able to induce accelerated vascular ageing to the same extent, and whether reinfections55 are associated with worse arterial stiffness.
(Continue . . . )
Excerpt from the accompanying press release:
Covid infection ages blood vessels, especially in women
18 Aug 2025
Topic(s): Risk Factors and Prevention
A Covid infection, particularly in women, may lead to blood vessels aging around five years, according to research published in the European Heart Journal [1] today.
Blood vessels gradually become stiffer with age, but the new study suggests that Covid could accelerate this process. Researchers say this is important since people with stiffer blood vessels face a higher risk of cardiovascular disease, including stroke and heart attack.
The study was led by Professor Rosa Maria Bruno from Université Paris Cité, France. She said: “Since the pandemic, we have learned that many people who have had Covid are left with symptoms that can last for months or even years. However, we are still learning what’s happening in the body to create these symptoms.
“We know that Covid can directly affect blood vessels. We believe that this may result in what we call early vascular ageing, meaning that your blood vessels are older than your chronological age and you are more susceptible to heart disease. If that is happening, we need to identify who is at risk at an early stage to prevent heart attacks and strokes.”
The study included 2,390 people from 16 different countries (Austria, Australia, Brazil, Canada, Cyprus, France, Greece, Italy, Mexico, Norway, Turkey, UK and US) who were recruited between September 2020 to February 2022. They were categorised according to whether they had never had Covid, had recent Covid but were not hospitalised, hospitalised for Covid on a general ward or hospitalised for Covid in an intensive care unit.
Researchers assessed each person’s vascular age with a device that measures how quickly a wave of blood pressure travels between the carotid artery (in the neck) and femoral arteries (in the legs), a measure called carotid-femoral pulse wave velocity (PWV). The higher this measurement, the stiffer the blood vessels and the higher the vascular age of a person. Measurements were taken six months after Covid infection and again after 12 months.
(SNIP)
“The CARTESIAN study makes the case that COVID-19 has aged our arteries, especially for female adults. The question is whether we can find modifiable targets to prevent this in future surges of infection, and mitigate adverse outcomes in those afflicted with COVID-19-induced vascular ageing.”
ENDS
Most people are familiar with the more obvious signs of `Long COVID' (see CDC list below):
But there may be more insidious health impacts that may not fully manifest for years (e.g. Hypertension, Cardiac problems, Diabetes, Neurodegenerative diseases like `Parkinson's', etc.), or only after repeated infections.
While there are proven ways to reduce the risk of reinfection (COVID vaccines, wearing face mask in public, avoiding indoor crowds, etc.), society - in an attempt to return to `normal' - has trivialized the COVID infection to the point that few now bother.
While many maintain that `what doesn't kill you makes you stronger', what we are learning about the many impacts of `Long COVID' makes a pretty good argument to the contrary.
https://afludiary.blogspot.com/2025/08/ehj-accelerated-vascular-ageing-after.html