{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T12:24:03Z","timestamp":1791721443368,"version":"4.3.4"},"reference-count":134,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Silesia in Katowice","award":["BNW-1-142\/N\/3\/K"],"award-info":[{"award-number":["BNW-1-142\/N\/3\/K"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Increasing long-term observations suggest that coronavirus disease 2019 (COVID-19) vasculopathy may persist even 1.5 years after the acute phase, potentially accelerating the development of atherosclerotic cardiovascular diseases. This study systematically reviewed the variability of brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) from the acute phase of COVID-19 through 16 months of follow-up (F\/U). Databases including PubMed, Web of Science, MEDLINE, and Embase were screened for a meta-analysis without language or date restrictions (PROSPERO reference CRD42025642888, last search conducted on 1 February 2025). The quality of the included studies was assessed using the Newcastle\u2013Ottawa Quality Scale. We considered all studies (interventional pre-post studies, prospective observational studies, prospective randomized, and non-randomized trials) that assessed FMD or cfPWV in adults (aged \u2265 18 years) with or after laboratory-confirmed COVID-19 compared with non-COVID-19 controls or that assessed changes in these parameters during the F\/U. Twenty-one studies reported differences in FMD, and 18 studies examined cfPWV between COVID-19 patients and control groups during various stages: acute\/subacute COVID-19 (\u226430 days from disease onset), early (&gt;30\u201390 days), mid-term (&gt;90\u2013180 days), late (&gt;180\u2013270 days), and very late (&gt;270 days) post-COVID-19 recovery. Six studies assessed variability in FMD, while nine did so for cfPWV during the F\/U. Data from 14 FMD studies (627 cases and 694 controls) and 15 cfPWV studies (578 cases and 703 controls) were included in our meta-analysis. FMD showed a significant decrease compared to controls during the acute\/subacute phase (standardized mean difference [SMD]= \u22122.02, p &lt; 0.001), with partial improvements noted from the acute\/subacute phase to early recovery (SMD = 0.95, p &lt; 0.001) and from early to mid-term recovery (SMD = 0.92, p = 0.006). Normalization compared to controls was observed in late recovery (SMD = 0.12, p = 0.69). In contrast, cfPWV values, which were higher than controls in the acute\/subacute phase (SMD = 1.27, p &lt; 0.001), remained elevated throughout the F\/U, with no significant changes except for a decrease from mid-term to very late recovery (SMD= \u22120.39, p &lt; 0.001). In the very late recovery, cfPWV values remained higher than those of controls (SMD = 0.45, p = 0.010). In the manuscript, we discuss how various factors, including the severity of acute COVID-19, the persistence of long-term COVID-19 syndrome, and the patient\u2019s initial vascular age, depending on metrics age and cardiovascular risk factors, influenced the time and degree of FMD and cfPWV improvement.<\/jats:p>","DOI":"10.3390\/life15040520","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T13:48:20Z","timestamp":1742824100000},"page":"520","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Variability in Arterial Stiffness and Vascular Endothelial Function After COVID-19 During 1.5 Years of Follow-Up\u2014Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-6269","authenticated-orcid":false,"given":"Danuta","family":"Loboda","sequence":"first","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-7976","authenticated-orcid":false,"given":"Krzysztof S.","family":"Golba","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Gurowiec","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5782-0937","authenticated-orcid":false,"given":"Aelita","family":"Bredelyt\u0117","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Klaip\u0117da University, LT-92294 Klaipeda, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-5354","authenticated-orcid":false,"given":"Art\u016bras","family":"Razbadauskas","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Klaip\u0117da University, LT-92294 Klaipeda, Lithuania"},{"name":"Chemotherapy Unit, Department of Oncology, Klaipeda University Hospital, LT-92288 Klaipeda, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0002-8591","authenticated-orcid":false,"given":"Beata","family":"Sarecka-Hujar","sequence":"additional","affiliation":[{"name":"Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2705","DOI":"10.1093\/cvr\/cvab298","article-title":"Cardiovascular disease and COVID-19: A consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA)","volume":"117","author":"Cenko","year":"2021","journal-title":"Cardiovasc. 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