Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/CFS)

Background Fatigue, exertion intolerance and post-exertional malaise are among the most frequent symptoms of Post-COVID Syndrome (PCS), with a subset of patients fulfilling criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). As SARS-CoV-2 infects endothelial cells, causing endo...

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Published in:Journal of translational medicine Vol. 20; no. 1; pp. 138 - 11
Main Authors: Haffke, Milan, Freitag, Helma, Rudolf, Gordon, Seifert, Martina, Doehner, Wolfram, Scherbakov, Nadja, Hanitsch, Leif, Wittke, Kirsten, Bauer, Sandra, Konietschke, Frank, Paul, Friedemann, Bellmann-Strobl, Judith, Kedor, Claudia, Scheibenbogen, Carmen, Sotzny, Franziska
Format: Journal Article
Language:English
Published: London BioMed Central 22.03.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
ACE2
Angiopoietin
Angiotensin
Angiotensin-converting enzyme 2
Biological markers
Biomarkers
Biomedical and Life Sciences
Biomedicine
Blood pressure
Chronic fatigue syndrome
Coronaviruses
COVID-19
COVID-19 - complications
Endothelial Cells
Endothelial dysfunction
Endothelin 1
Endothelium
Enzymes
Fatigue
Fatigue Syndrome, Chronic
Health aspects
Heart rate
Humans
Hyperemia
Hypoglycemia
Illnesses of Unknown Etiology
Infections
Interleukin 8
Intolerance
Long COVID
Medicine/Public Health
Myalgic encephalomyelitis/chronic fatigue syndrome
Patients
Peptidyl-dipeptidase A
Post-COVID syndrome
Reactive hyperaemia index
Risk factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Germany
Myalgic encephalomyelitis/chronic fatigue syndrome
Endothelial dysfunction
Reactive hyperaemia index
Post-COVID syndrome
Endothelin-1
ISSN:1479-5876, 1479-5876
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Summary:Background Fatigue, exertion intolerance and post-exertional malaise are among the most frequent symptoms of Post-COVID Syndrome (PCS), with a subset of patients fulfilling criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). As SARS-CoV-2 infects endothelial cells, causing endotheliitis and damaging the endothelium, we investigated endothelial dysfunction (ED) and endothelial biomarkers in patients with PCS. Methods We studied the endothelial function in 30 PCS patients with persistent fatigue and exertion intolerance as well as in 15 age- and sex matched seronegative healthy controls (HCs). 14 patients fulfilled the diagnostic criteria for ME/CFS. The other patients were considered to have PCS. Peripheral endothelial function was assessed by the reactive hyperaemia index (RHI) using peripheral arterial tonometry (PAT) in patients and HCs. In a larger cohort of patients and HCs, including post-COVID reconvalescents (PCHCs), Endothelin-1 (ET-1), Angiopoietin-2 (Ang-2), Endocan (ESM-1), IL-8, Angiotensin-Converting Enzyme (ACE) and ACE2 were analysed as endothelial biomarkers. Results Five of the 14 post-COVID ME/CFS patients and five of the 16 PCS patients showed ED defined by a diminished RHI (< 1.67), but none of HCs exhibited this finding. A paradoxical positive correlation of RHI with age, blood pressure and BMI was found in PCS but not ME/CFS patients. The ET-1 concentration was significantly elevated in both ME/CFS and PCS patients compared to HCs and PCHCs. The serum Ang-2 concentration was lower in both PCS patients and PCHCs compared to HCs. Conclusion A subset of PCS patients display evidence for ED shown by a diminished RHI and altered endothelial biomarkers. Different associations of the RHI with clinical parameters as well as varying biomarker profiles may suggest distinct pathomechanisms among patient subgroups.
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ISSN:1479-5876
1479-5876
DOI:10.1186/s12967-022-03346-2