ORCID Identifier(s)

0000-0002-9635-1117

Graduation Semester and Year

2022

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Kinesiology

Department

Kinesiology

First Advisor

Paul J Fadel

Abstract

Recent data indicates that the risk of developing cardiovascular disease (CVD) is augmented following coronavirus disease 2019 (COVID-19). Moreover, emerging data indicates that almost 50% of individuals who had COVID-19 experience persisting symptoms which are often debilitating, beyond the acute phase of the illness. This condition that is given the diagnosis post-acute sequalae of COVID-19 (PASC), also appears to be associated with cardiovascular complications. However, it is unclear what factors contribute to CVD risk following COVID-19 and PASC. Accordingly, the aim of this dissertation was to investigate potential factors that may contribute to adverse cardiovascular outcomes following COVID-19 with a focus on several key determinants of cardiovascular health, namely peripheral and cerebral vascular function, arterial stiffness, and blood pressure (BP). Given that young adults between 18 – 29 years account for almost 25% of the COVID-19 cases in the United States, study 1 and 2 focused on this population. In study 1, we tested the hypothesis that young, otherwise healthy adults who are beyond 4 weeks from a COVID-19 diagnosis would exhibit blunted peripheral and cerebral vasodilator function and increased central arterial stiffness compared with those who did not have COVID-19. The major novel findings from this study are that 1) peripheral macro- and microvascular vasodilator function are blunted in young adults still symptomatic from COVID-19, but not in those who were asymptomatic beyond the acute phase, and 2) cerebral vascular function and central arterial stiffness are unaffected beyond the acute phase irrespective of COVID-19 symptomology. Extending our findings, and those of others demonstrating detrimental effects of COVID-19 on vascular health in young adults, in study 2 we aimed to perform a comprehensive assessment of BP using ambulatory and laboratory techniques in this population. Findings from this study demonstrated that ambulatory and laboratory BP are higher in those closer to a COVID-19 diagnosis compared to those who are further out from diagnosis, suggesting a transient effect of COVID-19 to elevate BP in young adults. Finally, study 3 aimed to evaluate vascular health in PASC with a focus on investigating a potential link between cardiovascular health and symptomology. We show for the first time that patients with PASC have higher BP and central arterial stiffness whereas peripheral and cerebral vasodilator function appears to be unaffected. Moreover, although there were no associations between total symptom burden and measures of vascular function, we found that resting cerebral blood flow was inversely correlated with the severity of brain fog with those with the greatest severity of brain fog having the lowest cerebral blood flow. Collectively, the work described herein provides novel insight into the impact of COVID-19 on key determinants of cardiovascular health that may contribute to the greater CVD risk following COVID-19 in young adults and in PASC.

Keywords

SARS-CoV-2, Vascular function, Blood pressure, COVID-19

Disciplines

Kinesiology | Life Sciences

Comments

Degree granted by The University of Texas at Arlington

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