Cardiovascular Changes in Pregnant Women After Mild COVID-19 Infection: An Examination of Endothelial and Autonomic Functions

Introduction: Pregnant women constitute a special group regarding the cardiovascular effects of coronavirus disease 2019 .We employed transthoracic echocardiography, 24-hour rhythm Holter monitoring, and flow-mediated dilation (FMD) to evaluate the cardiac implications of COVID-19 in pregnant women diagnosed within the past six months.Methods: This study involved 80 pregnant women, 36 of whom were diagnosed with COVID-19 in the last six months of their pregnancy, while 44 served as healthy control subjects.The findings of transthoracic echocardiography, FMD, and 24-hour rhythm Holter monitoring were analyzed in all participants.All results were deemed statistically significant at a p-value threshold of less than 0.05.Results: Echocardiography, FMD, and Holter monitoring of the COVID-19 group were performed 43 days (range: 32-174) after diagnosis.FMD values were lower in the COVID-19 group (7.90 (3.45-14.09)%vs. 14.30(10.32-22.56)%,p=0.005).Epicardial adipose tissue (EAT) was thicker in the COVID-19 group (p=0.021).Systolic pulmonary artery pressure (sPAP) was lower in the COVID-19 group (p=0.013).The platelet-tolymphocyte ratio (PLR) was higher in patients with a history of ) vs. 118.90(101.10-152.29),p<0.001).Other echocardiographic and Holter parameters showed no differences.Adjusting for pregnancy week in a multivariable model attenuated the association between COVID-19 history and FMD (p=0.122).Gestational age acts as a confounder.Conclusions: Mild COVID-19 during pregnancy is associated with lower unadjusted FMD and higher PLR in the recovery phase.Gestational age is a major confounder.Future studies require strict age matching.