Introduction
A new international study led by researchers from Université Laval suggests that a COVID-19 infection may accelerate vascular aging in women, while men appear less affected. The research draws on data from about 2,100 participants across 18 countries and sheds light on sex-specific cardiovascular risks following SARS-CoV-2 infection.
The study design
Researchers assessed arterial stiffness by measuring pulse wave velocity (PWV) in the aorta, the body’s largest artery. The study sample consisted of three groups of individuals who had contracted COVID-19 but differed in illness severity: those who were not hospitalized (mostly mild infections), those hospitalized in a regular ward for moderate illness, and those admitted to an intensive care unit for severe infection. A control group comprised roughly 400 people who had never had COVID-19. This international cohort allowed investigators to compare vascular changes across severity levels and between the sexes.
Key findings
The results showed higher arterial stiffness among women in all COVID-19 exposure groups compared with the non-infected group, as indicated by increased PWV. When translated into aging equivalents, mild and moderate infections corresponded to about five extra years of vascular aging, while severe infection was associated with roughly ten extra years. Strikingly, no similar pattern appeared in men; their PWV did not differ significantly from controls, regardless of infection severity.
Why the gender difference?
The researchers propose that women’s typically stronger immune response to infections may drive greater inflammation, potentially causing more pronounced damage to the vascular lining. The endothelium—the innermost layer of blood vessels—appears to be a primary target, and when inflamed, it can lead to lasting dysfunction that manifests as stiffer arteries. As Professor Mohsen Agharazii noted, the lining cells are a key interface with the blood, and their compromise during COVID-19 can contribute to vascular aging.
Potential health implications
Arterial stiffness increases the heart’s workload and can raise blood pressure, consequences that may affect the heart, brain and kidneys over time. The team emphasizes that even a year after infection, the average arterial stiffness in women who had COVID-19 did not return to the level seen in those who never contracted the virus. This suggests that vascular changes could persist beyond the acute illness and warrant ongoing monitoring and management.
Implications for risk assessment and prevention
The researchers argue that a history of COVID-19 should be considered when assessing a woman’s cardiovascular risk, alongside well-established factors such as hypertension, diabetes, cholesterol, and lifestyle.
Healthy habits—regular physical activity, a balanced diet, and adherence to prescribed treatments for hypertension or other risk factors—remain important tools to mitigate risk. Clinicians might also tailor follow-up and screening for vascular health in women who have recovered from COVID-19, particularly those who experienced severe illness.
What this means for public health and future research
The study highlights a clear sex-specific vascular response to COVID-19, underscoring the need for targeted long-term research. Future work should determine whether the observed arterial stiffness is permanent for all individuals, how it evolves over time with intervention, and whether certain populations are more susceptible. As researchers continue to unpack the cardiovascular legacy of COVID-19, integrating infection history into risk assessment could help refine prevention strategies and clinical care for women.
Conclusion
These findings point to an important, sex-specific dimension of COVID-19’s impact on cardiovascular health. By recognizing COVID-19 as a potential contributor to vascular aging in women, healthcare providers can better stratify risk and promote preventive measures that protect the heart and other organs over the long term.
