Reply to the Letter regarding the Published Article “Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging”

Abstract

Dear Editor, Thank you for this opportunity to clarify concerns about the methodology of our study. We thank the authors for taking the time to express their views on our article. The authors of the letter have noted that there is a lack of data on the pre-COVID-19 vascular/health status of the cases, making it impossible to draw a definitive conclusion. They have also emphasized that there may be a risk of developing other concomitant medical problems during this time, resulting in altered aortic elasticity when evaluation is undertaken for a certain period of time after infection. As described in the Methodology section of our article, we excluded patients with a history of cerebrovascular disease, severe renal and liver failure, malignant disease, atrial fibrillation and atrial flutter, hypertension and diabetes mellitus, heart failure, moderate or severe heart valve stenosis or insufficiency, history of coronary artery bypass surgery, prosthetic heart valves, connective tissue diseases such as Marfan syndrome, ascending aorta >40 mm, bicuspid aortic valve; we attempted to exclude all clinical factors that may affect aortic elasticity based on broad exclusion criteria. In addition, considering the mean age of the patients in our study, it is one of our important advantages that it consists of young patients. Patient groups with similar demographic characteristics were included in the study [1]. As we did not have a chance to know who will be exposed to the SARS-CoV-2 virus, we aimed to minimize all clinical conditions that may affect aortic elasticity. The patients included in the study were patients in our pandemic hospital who had regular check-ups after recovering from COVID-19; they had no medical problems during the follow-up period that could affect aortic elasticity. Moreover, although the patients were included in the study at different time points between 3 and 6 months after diagnosis, the absence of correlation between aortic elasticity and the time elapsed since the diagnosis of COVID-19 in our correlation analysis indicates that the damage is not associated with time and is stable. Similar to our study results, a recent study showed impaired endothelial functions and arterial stiffness in COVID-19 survivors 4 months after infection [2]. Conflict of Interest Statement The authors have no conflict of interests to declare. Funding Sources None.