Covid-19 leaves a lasting impact on women’s arteries

A large international study reports that Covid-19 is linked with signs of older blood vessels months after infection, and the signal is strongest in women. The analysis points to a measurable change in how the body’s largest arteries behave, not just a vague sense of fatigue or brain fog.

The work ties prior infection to a higher risk profile that clinicians already know how to measure and manage. It strengthens the case for checking the health of central arteries in people with persistent post-covid symptoms.

Covid causes early aging of arteries

Rosa Maria Bruno of Paris Cité University led the CARTESIAN consortium, which tested whether infection is associated with accelerated vascular aging captured by study in adults. 

“COVID-19 is associated with early vascular aging in the long term, especially in women,” wrote Bruno and her collaborators.

The team enrolled 2,390 people across 34 centers in 16 countries between September 2020 and February 2022. Participants were assessed about six months after infection for those exposed.

The individuals were grouped as never infected, infected without hospitalization, hospitalized on general wards, or admitted to intensive care. This design allowed the researchers to compare arterial measures across clear clinical strata.

Measuring vascular age

Aortic pulse wave velocity (PWV) is a standard noninvasive marker of arterial stiffness, and higher values predict cardiovascular events beyond traditional risk factors. Clinicians use it because faster pressure waves mean stiffer, less compliant aortas.

The study tracked how quickly a pressure wave moved from the carotid to the femoral artery using validated devices, with reference ranges based on age and blood pressure. This standardization helps ensure that different centers share a common understanding of what counts as “higher than expected.”

SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) to enter cells, which provides a plausible entry point for vascular effects. Injury to the endothelium has been documented in Covid-19 and long Covid, aligning biology with the observed stiffness signal.

Covid-19 effects on women’s arteries

Even after accounting for factors like age, smoking, or blood pressure, women who had Covid-19 showed stiffer arteries than women who had never been infected. The effect became stronger the more severe their illness had been.

For women who recovered at home, their arteries looked about half a step older than expected. Those who had been hospitalized showed a slightly bigger shift, and women who ended up in intensive care showed the largest jump of all.

Men, on the other hand, did not show the same pattern compared with men who had not been infected.

To put it in perspective, the increase seen in women who had mild cases was similar to adding about five years of wear and tear to their blood vessels. In the most severe cases, the change looked closer to seven or eight years. That kind of shift can make a real difference for long-term heart health.

Why are the impacts stronger in women?

Females often mount stronger innate and adaptive immune responses than males, and those differences have been tied to divergent Covid-19 outcomes. A more robust response can help early, yet it may sustain inflammation that lingers.

Large U.S. cohort work has also linked female sex to a higher risk of long Covid, especially in midlife, independent of other risk factors. This echoes the study’s finding that persistent symptoms and arterial stiffness track together in women.

Those converging lines do not prove cause and effect. They do point to a consistent story that clinicians can use while research fills in the gaps.

What changed over 12 months

In participants who returned for a second visit about a year later, PWV stabilized or even declined in those with prior infection, while it crept up in controls as you would expect with normal aging. That suggests parts of the stiffness signal may ease over time.

An editorial described the pattern as “an accelerated yet partially reversible clock.” That framing fits the longitudinal data without overselling certainty.

Vaccination at the first visit was associated with lower PWV among infected women, a signal still present at 12 months, though confounding cannot be ruled out in observational data. This finding supports, but does not by itself prove, a protective vascular effect.

Why this matters for everyday care

PWV is quick to measure, repeatable, and already used in preventive cardiology. It adds signals beyond standard clinic numbers, which makes it useful when symptoms linger but routine labs look fine.

For women with prior Covid infection and ongoing symptoms, especially in midlife, a vascular checkup can inform tighter blood pressure control, lipid management, and exercise planning. It also gives patients and clinicians a shared, objective marker to follow over time.

The study is published in the European Heart Journal.

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