Abstract
Background: It has been widely reported that the Severe Acute
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by
using the Angiotensin Converting Enzyme 2 (ACE2) receptor, but vascular
impairment described during coronavirus disease 2019 (COVID-19)
infection is primarily due to the direct involvement of the endothelial
cells by the virus or secondarily to the inflammatory host response is
currently unknown. Methods: We therefore aimed to demonstrate in vivo
the presence of endothelial dysfunction in six COVID-19 patients without
cardiovascular risk factors or pre-existing cardiac condition, using the
Endo-PAT 2000, a device able to measure endothelial vasodilation
function in a rapid and non-invasive way. Results: Four patients were
positive for endothelial dysfunction, with RHI values between 1.13-1.56
(average value 1.32, normal values >1.67); in one of the
two negative patients the reported RHI value was slightly above the
cutoff (1.72). Conclusion: Our findings confirm that COVID-19 patients
are at higher risk of developing endothelial dysfunction. In addition,
our results demonstrate that endothelial impairment may occur even in
the absence of cardiovascular risk factors.