Covid-19 seems to age blood vessels – but only among women

Covid-19 seems to accelerate the ageing of blood vessels, but perhaps only among women.

The infection has previously been linked to cardiovascular complications, like heart disease, but how it has this effect isn’t entirely clear. To learn more, Rosa Maria Bruno at the Université Paris Cité in France and her colleagues recruited 2390 people, aged 50 on average, from 16 countries – including the UK and US – between September 2020 and February 2022.

Some of them had tested positive for SARS-CoV-2, the virus that causes covid-19, or had antibodies against it despite not being vaccinated, a sign that they had been infected. The others had only ever tested negative for the virus and had no signs of prior infection.

The health of their arteries was assessed by measuring how fast a pressure wave passed between the carotid artery in their neck and the femoral arteries in their legs. This is a measure of artery stiffness, which increases naturally with age, with less flexible arteries raising the risk of heart disease.

The researchers found that among the women in the study, a known SARS-CoV-2 infection was linked to stiffer arteries. This also seemed to increase alongside the severity of their infection. For instance, women who were hospitalised with covid-19 had a vascular age that was around five years older than their uninfected counterparts, rising to 7.5 years among those admitted to intensive care.

The researchers controlled for other factors that can influence artery stiffness, like smoking and obesity.

But none of these effects occurred among the men. Previous research suggests that women react more strongly to infections than men and are less able to dial down their immune response, which could lead to damaging inflammation. Bruno says she was expecting to see some difference between the sexes, but not this much.

The findings could also shed some light on long covid, which seems to be more common among women. At a six-month follow-up, the stiffness of the women’s arteries had improved slightly, but was still particularly high among those with lingering covid-19-related complications. “Here we have demonstrated there is something measurable in the blood vessels that corresponds to the symptoms of long-covid patients,” says Bruno.

It’s possible that some of the people in the uninfected group may have unknowingly had a mild infection, affecting the validity of the results.

Nevertheless, Vassilios Vassiliou at the University of East Anglia in the UK says the study is robust and could help identify people with long covid. “The study is the first large international multicentre investigation to demonstrate that covid-19 is associated with accelerated vascular ageing,” he says. “The findings may also contribute to a better mechanistic understanding of post covid-19 syndrome, potentially paving the way for targeted pharmacological interventions.”