Endothelial function disorders in children with COVID-19 infection: results of own study
DOI:
https://doi.org/10.15574/PP.2023.94.106Keywords:
children, endothelial dysfunction, endothelial cell, post-acute coronavirus (COVID-19) syndromeAbstract
Purpose - to learn the features of clinical condition and state of endothelial function as the marker of the development of cardiovascular pathology in children who suffered from COVID-19.
Materials and methods. The research group consisted of 70 children aged 7-14 without chronic pathology who suffered from COVID-19 and had laboratory confirmation of the disease. Assessment of the functioning of the vessels’ endothelium was done by studying the dynamics of blood flow in the brachial artery and changes of it diameter at rest and during reactive hyperemia after an occlusion test. Statistical assessment of the obtained data was carried out by the application package «Statistica 10.0 for Windows» using the method of variational statistics. Student’s t-test was calculated to assess the reliability of mean values differences.
Results. The state of endothelial function show that 85.4% of children after COVID-19 infection had signs of endothelial dysfunction, mainly hypoergic (32.9%) and paradoxical (30%) forms, while normoergic function of the endothelium was found only in 14.6% of children. In the same time in the group of children who did not suffer from COVID-19, was found that the normorergic form registrated in 80.0%, hyperergic endothelial dysfunction was found in 13.3% of children, and hypoergic - in 6.7% of children. Paradoxical endothelial dysfunction was not found in any child from this group.
Conclusions. COVID-19 infection has negative consequences on the endothelium function and contributes to the development of endothelial dysfunction regardless of the severity of the disease course. Our results obtained the need of future study to develop an affordable and low-cost algorithm for routine use and identification of children with markers of lesion of cardiovascular system.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Anderson T, Meredith I, Yeung A, Frei B, Selwyn A, Ganz P. (1995). The effect of cholesterollowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N. Engl. J. Med. 332: 488-493. https://doi.org/10.1056/NEJM199502233320802; PMid:7830729
Avdeeva IV, Polezhaeva KN, Burko NV i dr. (2022). Vliyanie infektsii SARS-CoV-2 na strukturno-funktsionalnyie svoystva arteriy. University proceedings. Volga region. Medical sciences: 2. https://doi.org/10.21685/2072-3032-2022-2-2
Bonetti P, Lerman L, Lerman A. (2003). Endothelial dysfunction - a marker of atherosclerotic risk. Arterioscl. Throm. Vas. 23: 168-175. https://doi.org/10.1161/01.ATV.0000051384.43104.FC; PMid:12588755
Bradley VC, Kuriwaki S, Isakov M et al. (2020). Unrepresentative big surveys significantly overes- timate US vaccine uptake. Nature: 695-700. https://doi.org/10.1038/s41586-021-04198-4; PMid:34880504 PMCid:PMC8653636
Davies P, Evans C, Kanthimathinathan HK et al. (2020). Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS- CoV-2 (PIMS-TS) in the UK: a multicentre observational study. Lancet Child Adolesc Health. 4 (9): 669-677. https://doi.org/10.1016/S2352-4642(20)30215-7; PMid:32653054
Flammer A, Anderson T, Celermajer D et al. (2012). The assessment of endothelial function: from research into clinical practice. Circulation. 126: 753-767. https://doi.org/10.1161/CIRCULATIONAHA.112.093245; PMid:22869857 PMCid:PMC3427943
Flammer A, Sudano I, Hermann F et al. (2008). Angiotensin-converting enzyme inhibition improves vascular function in rheumatoid arthritis. Circulation. 117: 2262-2269. https://doi.org/10.1161/CIRCULATIONAHA.107.734384; PMid:18427133
Gao Y-P, Zhou W, Huang P-N et al. (2022). Persistent Endothelial Dysfunction in Coronavirus Disease-2019 Survivors Late After Recovery. Front. Med. 9: 809033. https://doi.org/10.3389/fmed.2022.809033; PMid:35237624 PMCid:PMC8882598
Gewaltig MT, Kojda G. (2002). Vasoprotection by nitric oxide: mechanisms and therapeutic potential. Cardiovasc. Res. 55 (2): 250-260. https://doi.org/10.1016/S0008-6363(02)00327-9; PMid:12123764
Ihnatova TB. (2015). State of endothelial function within the healthy children of the younger school age according to data of triplex ultrasonic research. Sovremennaya pediatriya. 8 (72): 54-56. https://doi.org/10.15574/SP.2015.72.54
Jung F, Krüger-Genge A, Franke RP et al. (2020). COVID-19 and the endothelium. Clin. Hemorheol. Microcirc. 75 (1): 7-11. https://doi.org/10.3233/CH-209007; PMid:32568187 PMCid:PMC7458498
Kovalenko SV. (2020). Dosvid zastosuvannia metodiv syndromno-patohenetychnoi terapii pry pnevmonii, sprychynenii COVID-19, v umovakh pulmonolohichnoho viddilennia. Medychna hazeta «Zdorovia Ukrainy 21 storichchia». 13-14: 481-482.
Koyama Y. (2013). Endothelin systems in the brain: Involvement in pathophysiological responses of damaged nerve tissues. Biomolecular Concepts. 4 (4): 335-347. https://doi.org/10.1515/bmc-2013-0004; PMid:25436584
Kvashnina L, Ignatova T. (2016). The condition within the healthy children of younger school age of an endothelial function according to a biochemical method of research. Perinatologiya i pediatriya. 4 (68): 86-88. https://doi.org/10.15574/PP.2016.68.86
Kvashnina LV, Ihnatova TB. (2015). Sposib otsinky endotelialnoi funktsii ditei. Patent Ukrainy na korysni modeli No. 97120.
Maier CL, Truong AD, Auld SC et al. (2020). COVID-19-associated hyperviscosity: a link between inflammation and thrombophilia? Lancet. 395 (10239): 1758-1759. https://doi.org/10.1016/S0140-6736(20)31209-5; PMid:32464112
McGonagle D, Sharif K, O'Regan A, Bridgewood C. (2020). The role of cytokines including Interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 19 (6): 102537. Epub 2020 Apr 3. https://doi.org/10.1016/j.autrev.2020.102537; PMid:32251717 PMCid:PMC7195002
Monteil V, Prado P, Hagelkrüys A et al. (2020). Inhibition of SARS-CoV-2 infections in engineered human tissues using clinical-grade soluble human ACE2. Cell. 181 (4): 905-913.e7. Epub 2020 Apr 24. URL: https://www.cell.com/pbassets/products/coronavirus/CELL_CELL-D-20-00739.pdf. https://doi.org/10.1016/j.cell.2020.04.004; PMid:32333836 PMCid:PMC7181998
Multisystem inflammatory syndrome (MIS-C). (2021). Information for Pediatric Healthcare Providers. URL: https://www.cdc.gov/mis/index.html (last accessed 25.06.2021).
NAMN Ukrainy. (2019). Zvit pro NDR Instytutu pediatrii, akusherstva i hinekolohii NAMN Ukrainy. 1: 1-57.
Panigada M, Bottino N, Tagliabue P et al. (2020). Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. JTH. 18 (7): 1738-1742. https://doi.org/10.1111/jth.14850; PMid:32302438 PMCid:PMC9906150
Pober JS, Sessa WC. (2007). Evolving functions of endothelial cells in inflammation. Nat Rev Immunol. 7: 803-815. https://doi.org/10.1038/nri2171; PMid:17893694
Sagaydachniy АА. (2018, Sep). Reactive hyperemia test: methods of analysis, mechanisms of reaction and prospects. Regional Blood Circulation and Microcirculation. 17 (3): 5-22. https://doi.org/10.24884/1682-6655-2018-17-3-5-22
Stephenson T, Shafran R, De Stavola B et al. (2021). Long COVID and the mental and physical health of children and young people: national matched cohort study protocol (the CLoCk study). BMJ Open. 11 (8): e052838. https://doi.org/10.1136/bmjopen-2021-052838; PMid:34446502 PMCid:PMC8392739
Taddei S, Virdis A, Ghiadoni L, Mattei P, Salvetti A. (1998). Effects of angiotensin converting enzyme inhibition on endothelium-dependent vasodilatation in essential hypertensive patients. J. Hypertens. 16: 447-456. https://doi.org/10.1097/00004872-199816040-00006; PMid:9797190
Urano T, Suzuki Y. (2012). Accelerated fibrinolysis and its propagation on vascular endothelial cells by secreted and retained tPA. J Biomed Biotechnol: 208108. https://doi.org/10.1155/2012/208108; PMid:23118500 PMCid:PMC3478939
Varga Z, Flammer A, Steiger P et al. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 395 (2): 1417-1418. https://doi.org/10.1016/S0140-6736(20)30937-5; PMid:32325026
Wright FL, Vogler TO, Moore EE et al. (2020). Fibrinolysis shutdowncorrelates to thromboembolic events in severe COVID-19 infection. J Am Coll Surg. 231 (2): 193-203.e1. Epub 2020 May 15. https://doi.org/10.1016/j.jamcollsurg.2020.05.007; PMid:32422349 PMCid:PMC7227511
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