Abstract 280: Association Between Sars-cov-2 Infection and Abdominal Aortic Aneurysms (Aaas)

Objectives: SARS-CoV-2 infection worsens cardiovascular outcomes. We studied the association of SARS-CoV-2 infection with clinical, and the influence of SARS-CoV-2 spike proteins on experimental, AAA progression. Methods: AAA patients aged ≥50 years with two diameter measurements and SARS-CoV-2 infection status were screened in an institutional research database during the period of January 1, 2020 to December 31, 2021. The association of risk factors including SARS-CoV-2 infection with AAA progression was analyzed. The influence of SARS-CoV-2 spike proteins on experimental AAAs was assessed in wild type and human ACE2 transgenic mice by injecting SARS-CoV-2 spike proteins. Results: We identified 175 AAA patients (26 patients with SARS-CoV-2 infection) with at least two aortic diameter measurements. Mean initial diameter and median annual AAA enlargement rate were 39.1 mmm and 0.9 mm annually, respectively. Univariate analysis found SARS-CoV-2 infection as the only factor associated with rapid AAA enlargement (>2.7 mm/year). In multivariate logistic regression, SARS-CoV-2 infection (odds ratio: 9.7), chronic kidney disease (3.8) and ever smokers (2.0) were associated with rapid AAA enlargement. A reverse association was noted for patients with cancers (0.2), cerebrovascular disease (0.3), diameter measurement interval (0.8) and body mass index (0.9). No association was noted with any other factors. Additionally, recombinant SARS-CoV-2 spike protein 1 or its receptor binding domain, not spike protein 2, treatment accelerated AAA progression in wild type mice. SARS-CoV-2 spike protein 1 treatment also diminished AAA attenuation in human ACE2 transgenic mice. Conclusions: Clinical and experimental data suggest that SARS-CoV-2 infection may promote AAA progression. Large cohort validation studies are required to determine whether AAA screening, surveillance and interventional criteria should be modified during or after SARS-CoV-2 infection.