Rationale: Infection with severe acute respiratory syndrome coronavirus (SARS-CoV) 2 could result in endothelial dysfunction with increased risk of arterial thrombotic events by downregulating the expression of angiotensin converting enzyme 2 (ACE2). Endothelial function can be easily and non-invasively determined by carotid artery reactivity (CAR) testing. Objective: To investigate the predictive value of endothelial dysfunction, measured by carotid artery reactivity testing, for 1-year cardiovascular events in patients with past COVID-19 infection. Study design: A prospective observational longitudinal cohort study. Study population: Patients recovered from confirmed infection with SARS-CoV2. Main study parameters/endpoints: macrovascular endothelial function measured by carotid artery reactivity testing.
Diagnostic Test: Carotid Artery Reactivity Testing
The carotid artery reactivity (CAR) test assesses macrovascular endothelial function by measuring the carotid artery diameter in response to sympathetic stimulation. Participants are in the supine position with the neck extended for assessment of the carotid artery. Left carotid artery diameter is recorded continuously during baseline (30 seconds) and during immersion of the right hand up to the wrist in icy water (4°C) for 3 minutes. CAR can either represent a dilatory response (normal endothelial function) or a constrictive response (endothelial dysfunction) of the carotid artery.
Other Name: Cold pressor test
Inclusion Criteria:
- Confirmed SARS-CoV2 infection by polymerase chain reaction on nasopharyngeal swab,
sputum or bronchoalveolar lavage.
- At least 6 and no more than 20 weeks after resolution of COVID-19 related symptoms
- ≥ 16 years old
Exclusion Criteria:
- Recent (<3 months) angina pectoris, myocardial infarction, stroke, or heart failure
- Raynaud syndrome, scleroderma, complex regional pain syndrome of the upper extremity
or presence of arteriovenous fistula or open wounds on both the upper extremities.
Bernhoven
Uden, Netherlands