SYSTEMIC INFLAMMATION IN PATIENTS WITH STABLE CORONARY HEART DISEASE IN THE POST-COVID PERIOD DEPENDING ON THE SEVERITY OF COVID-19 TRANSFER
Authors:   Novosibirsk State Medical University, Yakhontov Davyd A. , Derisheva Daria A. ,   Novosibirsk State Medical University, Lukinov Vitaly L. ,   Institute of Computational Mathematics and Mathematical Geophysics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk
Published: October 2024

Background. In the post-covid period, systemic inflammation plays an important role in the development of coronary heart disease (CHD) and has a significant impact on the cardiovascular system by improving inflammatory responses, which may lead to progression of atherosclerosis, worsen the condition, and increase the likelihood of complications in patients with stable CHD. Objective. To evaluate clinical and laboratory indices of systemic inflammation in patients with stable coronary heart disease in the post-covid period depending on the severity of COVID-19. Material and methods. An observational descriptive study of two parallel groups including 416 patients with stable CHD who underwent COVID-19 more than 12 weeks ago was conducted. Patients were divided into two groups according to the severity of COVID-19 in the acute period. Group 1 included 203 patients (male 132 (65.3%), female 71 (34.7%)) aged 59.7±6.9 years who had mild SARS-CoV-2 infection; Group 2 included 213 patients (male 132 (62.0%), female 81 (38.0%)) aged 61.1±6.1 years who had moderate COVID-19. Monocyte chemoattractant protein-1 (MCP-1); vascular endothelial growth factor (VEGF); interleukins; interleukins (ILs): IL-1β, IL-4, IL-6, IL-8, IL-10, and IL-18 were determined by PCR. The C3 and C4 components of the complement system were also determined by the immunoturbidimetric method. Statistical calculations were performed in the RStudio software (version 2022.07.2+576, USA) in the R language (version 4.1.3 (2022-03-10), Austria). Results. Uncontrolled hypertension (p<0.001) and grade II obesity (p=0.005) were more frequent in the group of patients with stable CHD who underwent moderate COVID-19. In the same group, type 2 DM (p=0.031), atrial fibrillation (p = 0.029), and grade III angina pectoris (p=0.006) were more frequent, and Simpson's EF was lower (p<0.001) compared to the group of patients with mild SARS-CoV-2 infection. In patients with IBS who underwent COVID-19 of moderate severity, there was a statistically significant increase in the levels of pro-inflammatory cytokines - MCP-1, TNF-α, IL-1β (p<0.01) and the C3 component of the complement system (p=0.048) compared to patients with a mild course of infection in the acute period. In patients with stable coronary heart disease who underwent COVID-19, significant correlations were observed between the studied pro-inflammatory blood markers. Multiple and strongest associations were found for MCP-1, IL-10, IL-1β, IL-2, VEGF and the components of the complement system C3 and C4, which can be used as markers of the unfavorable course of the post-acute period in patients with IBS. Conclusion. Patients with stable CHD who underwent moderate SARS-CoV-2 infection are characterized by a higher incidence of uncontrolled AH, type 2 DM, and atrial fibrillation in the remote period. These patients also have higher levels of pro-inflammatory cytokines MCP-1, TNF-α and IL-1β, which correlate significantly with the severity of the disease and can serve as a predictor of its progression.