by Elana Gotkine

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with more rapid progression of coronary artery lesion-based plaque volume, according to a study published online Feb. 4 in Radiology.

Neng Dai, M.D., from Fudan University in Shanghai, and colleagues examined the impact of SARS-CoV-2 infection on coronary inflammation and plaques using coronary computed tomography angiography. Lesions of patients with and without SARS-CoV-2 infection were compared in terms of the quantitative total and compositional percent atheroma volume (PAV) and annualized PAV change, presence of high-risk plaque, and attenuation of lesion-specific pericoronary adipose tissue (PCAT) at baseline and follow-up.

Data were included for 2,108 coronary artery lesions in 690 patients with SARS-CoV-2 infection and 480 lesions in 113 patients without SARS-CoV-2 infection. The researchers found that lesions in patients with SARS-CoV-2 infection demonstrated more rapid progression of overall PAV (0.90 versus 0.62% per year) and noncalcified PAV (0.78 versus 0.42% per year) compared with lesions in patients without SARS-CoV-2 infection.

Despite similar prevalence at baseline, lesions in patients with SARS-CoV-2 infection had a higher incidence of becoming high-risk plaque (21.0 versus 15.8%) and higher incidence of PCAT attenuation of –70.1 Hounsfield units or higher (27.1 versus 19.8%). A higher risk for target lesion failure was seen in lesions in patients with COVID-19 (10.4 versus 3.1%; adjusted hazard ratio, 2.90).

"Our findings suggest that SARS-CoV-2 infection may exacerbate cardiovascular risk by accelerating the advancement of susceptible plaque types and coronary inflammation, thus offering a potential mechanistic rationale for the link between prior SARS-CoV-2 infection and adverse clinical events," the authors write.

More information: Neng Dai et al, SARS-CoV-2 Infection Association with Atherosclerotic Plaque Progression at Coronary CT Angiography and Adverse Cardiovascular Events, Radiology (2025). DOI: 10.1148/radiol.240876

Jonathan R. Weir-McCall et al, COVID-19 Infection and Coronary Plaque Progression: An Early Warning of a Potential Public Health Crisis, Radiology (2025). DOI: 10.1148/radiol.243767

Journal information: Radiology 

© 2025 HealthDay. All rights reserved.