# Cardiovascular Risk, Vascular and Kidney Damage in COVID-19 Survivors

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2022 · $803,324

## Abstract

PROJECT SUMMARY
The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis, characterized by pneumonia and
multiorgan dysfunction. We previously demonstrated that community-acquired pneumonia increases the long-
term risk of cardiovascular disease. There is an urgent need to investigate the incidence and mechanisms of
cardiovascular disease in COVID-19 survivors. Thus, we propose a novel investigation of the intermediate and
long-term cardiac, vascular, and renal consequences of COVID-19.
Acutely, COVID-19 is associated with microvascular and macrovascular thrombotic events and inflammatory-
and stress-related injury in the heart, kidneys, and vasculature that may put COVID-19 survivors at particularly
elevated risk of chronic complications. Our study team has combined expertise in the study of post-pneumonia
cardiovascular risk, vascular and kidney pathophysiology, epidemiologic outcomes research, and
implementation of longitudinal prospective cohort studies. Our goal is to examine the natural history of cardiac,
vascular, and kidney disease in COVID-19 survivors, and to identify risk factors for adverse longitudinal
outcomes in these patients. We propose a prospective cohort study evaluating 1) cardiovascular events in a
large, electronic health record-based cohort of survivors of COVID-19 in our health system compared with
matched controls (“MACE cohort”) and 2) detailed vascular and renal phenotyping in a smaller cohort of COVID-
19 survivors compared with matched controls (“deep phenotyping cohort”). In the MACE cohort, we will collect
detailed hospitalization, demographic, and clinical data as well as records for post-COVID-19 hospitalizations.
An expert physician panel will prospectively adjudicate hospitalization records to evaluate for post-COVID-19
MACE (heart failure hospitalization, acute coronary syndrome, serious arrhythmia, stroke, peripheral artery
disease, and death). In the deep phenotyping cohort, we will perform serial quantitative measurements of
vascular health in large, medium-sized, and small arteries, specifically: (1) pulse wave velocity (the reference
standard measure of large artery stiffness), (2) flow-mediated dilation (a measure of endothelial function), and
(3) microvascular structure assessed by sublingual imaging. We will also perform serial measurements of kidney
function (estimated glomerular filtration rate, albuminuria, markers of tubular injury, and exploratory ultrasound
images to estimate fibrosis). We aim to assess the long-term incidence of and risk factors for MACE in COVID-
19 survivors, and to evaluate the trajectory of microvascular and macrovascular health and kidney function over
time in these patients. Our mechanism-driven approach will provide critical guidance on longitudinal
cardiovascular risk and vascular and kidney damage following COVID-19 infection. The results of this study will
enhance our understanding of the long-term target organ effects of COVID-19 and identify risk f...

## Key facts

- **NIH application ID:** 10364096
- **Project number:** 1R01HL157108-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** JULIO ALONSO CHIRINOS MEDINA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $803,324
- **Award type:** 1
- **Project period:** 2022-01-20 → 2026-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10364096

## Citation

> US National Institutes of Health, RePORTER application 10364096, Cardiovascular Risk, Vascular and Kidney Damage in COVID-19 Survivors (1R01HL157108-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10364096. Licensed CC0.

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