Covid-19 may accelerate the ageing of blood vessels—but this effect appears to be largely limited to women.
Previous research has connected SARS-CoV-2 infection with cardiovascular complications, including heart disease, though the mechanisms behind these effects remain unclear.
To investigate, Rosa Maria Bruno of Université Paris Cité in France and colleagues conducted a multinational study involving 2,390 participants, averaging 50 years of age, across 16 countries—including the UK and the US—between September 2020 and February 2022.
Participants were divided into two groups: those who had tested positive for SARS-CoV-2 or had antibodies indicating prior infection despite no vaccination, and those who had never tested positive and showed no evidence of previous infection.
Researchers assessed arterial health by measuring the speed at which a pressure wave traveled between the carotid artery in the neck and the femoral arteries in the legs—a standard measure of arterial stiffness. Arteries naturally stiffen with age, and reduced flexibility is linked to higher cardiovascular risk.
The study revealed that SARS-CoV-2 infection was associated with stiffer arteries in women, with severity of infection correlating to greater vascular ageing.
Women hospitalized with covid-19 showed vascular ages roughly five years older than uninfected women, rising to 7.5 years among those admitted to intensive care. The research team accounted for other factors affecting arterial stiffness, such as smoking and obesity.
No significant effects were observed among men. Previous studies suggest that women may have stronger immune responses but a reduced ability to suppress inflammation, which could contribute to vascular damage. Bruno noted that while she expected sex-based differences, the magnitude of the disparity was surprising.
The findings may also provide insight into long covid, which is more commonly reported among women. Six months post-infection, women’s arterial stiffness had decreased slightly but remained elevated, particularly among those experiencing ongoing covid-related complications.
“We have demonstrated there is something measurable in the blood vessels that corresponds to the symptoms of long-covid patients,” Bruno said.
Some participants in the uninfected group may have had mild, undetected infections, potentially affecting results. Nevertheless, Vassilios Vassiliou of the University of East Anglia called the study “robust” and said it could help identify individuals at risk for long covid.
“This is the first large international multicentre investigation to demonstrate that covid-19 is associated with accelerated vascular ageing,” he said. “The findings may also advance mechanistic understanding of post-covid syndrome and guide targeted treatments.”
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