CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF PATIENTS WITH ACUTE CORONARY SYNDROME WHO UNDERWENT COVID-19
DOI: 10.22138/2500-0918-2023-20-1-31-39
E.A. Safronova¹, L.V. Ryabova¹, A.V. Zurochka²
¹FGBOU of the South Ural State Medical University of the Ministry of Health of the Russian Federation, Chelyabinsk, Russian Federatian;
²Institute of Immunology and Physiology of the Ural Branch
of the Russian Academy of Sciences, Yekaterinburg, Russian Federation
Abstract. This study examined the difference between neutrophil phagocytosis and humoral immunity in patients with acute coronary syndrome (ACS) who had Covid-19 compared with those without a new coronavirus infection. We examined 65 men with ACS aged 40 to 65 who had Covid-19 within 6 months to one year prior to the study, and 20 patients with ACS who did not have a new coronavirus infection and were vaccinated against coronavirus. All patients had critical stenoses of the coronary arteries and underwent stenting of these vessels in the first 3 days from the moment of admission to the hospital. In the group of patients with ACS who did not have covid (vaccinated), persons with unstable angina prevailed, while in the group with Covid-19, patients with acute myocardial infarction (AMI) prevailed, and to a greater extent with ST elevation (nST), which is a more severe form of ACS. All deceased patients with ACS had Covid-19. It was found that in patients who underwent Covid-19, Jg M (p <0.0001) and Jg G (p <0.01) to the virus significantly predominated in comparison with those who did not have a new coronavirus infection (vaccinated). Patients who underwent Covid-19 and ACS (p<0.05) showed a higher duration of hospitalization, blood troponin level, almost 3 times, and a Grace risk, an increased number of stents, and complications — stent thrombosis. They also showed a tendency to increase the total number of leukocytes, neutrophils, neutrophil-lymphocyte ratio in comparison with patients who did not have a new coronavirus infection. Higher levels of monocytes were observed both in absolute and relative values, at the same time lower values of activity and intensity of phagocytosis and phagocytic number of neutrophils were determined in people with ACS and Covid-19 compared to those without a new coronavirus infection. In the group of patients with ACS who underwent Covid-19, higher levels of general and specific Ig M, G to Covid-19 were noted.
Keywords: Covid-19, acute coronary syndrome, unstable angina, acute myocardial infarction, neutrophil phagocytosis, immunoglobulins
There is no conflict of interest.
Contact details of the corresponding author:
Eleonora A. Safronova
safronovaeleonora68@gmail.com
Received 16.01.2023
For citation:
Safronova E.A., Ryabova L.V., Zurochka A.V. Clinical and immunological characteristics of patients with acute coronary syndrome who underwent COVID-19. [Online] Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2023, Vol. 20, no. 1-2, pp. 31–39. DOI: 10.22138/2500-0918-2023-20-1-31-39 (In Russ)
REFERENCES:
1. Ackermann M., Anders H.J., Bilyy R., Bowlin G.L., Daniel C., De Lorenzo R. 3t al. Patients with COVID-19: in the dark-NETs of neutrophils. Cell Death Differ. 2021 Nov; 28(11):3125-3139. doi: 10.1038/s41418-021-00805-z. Epub 2021 May 24. PMID: 34031543; PMCID: PMC8142290.
2. Sreejit G., Abdel-Latif A., Athmanathan B., Annabathula R., Dhyani A., Noothi S.K. et al. Neutrophil-derived S100A8/A9 amplify granulopoiesis after myocardial infarction. Circulation. 2020 Mar 31; 141(13):1080-1094. doi: 10.1161/CIRCULATIONAHA.119.043833. Epub 2020 Jan 16. PMID: 31941367; PMCID: PMC7122461.
3. Kologrivova I., Shtatolkina M., Suslova T., Ryabov V. Cells of the immune system in cardiac remodeling: main players in resolution of inflammation and repair after myocardial infarction. Front Immunol., 2021 Apr 2, 1: 664457. doi: 10.3389/fimmu.2021.664457.
4. Freidlin I. S. Methods for studying phagocytic cells in assessing the immune status of a person: Proc. allowance. L.; 1986. 37 p. ((in Russian).
5. Viksman M.E., Mayansky A.N. A method for assessing the functional activity of human neutrophils by the reduction reaction of nitroblue tetrazolium: Method. recommendations. Ministry of Health of the RSFSR. Kazan: n.i.; 1979. 14 p. ((in Russian).
6. Kasko O.V. Statistical analysis of data in medical research: at 2 pm. Minsk: MGEU im. HELL. Sakharov; 2014. Part I. 127 p. ((in Russian).
7. Masso-Silva J.A., Moshensky A., Lam M.T.Y., Odish M.F., Patel A., Xu L.et al. Increased peripheral blood neutrophil activation phenotypes and neutrophil extracellular trap formation in critically ill coronavirus disease 2019 (COVID-19) patients: a case series and review of the literature. Clin Infect Dis. 2022 Feb 11; 74(3):479-489. doi: 10.1093/cid/ciab437. Erratum in: Clin Infect Dis. 2022 May
30;74(10):1889-1890. PMID: 33988226; PMCID: PMC8241438.
8. Afari ME, Bhat T. Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update. Expert Rev Cardiovasc Ther. 2016;14(5):573-7. doi: 10.1586/14779072.2016.1154788. Epub 2016 Mar 4. PMID: 26878164.
9. Fan W, Zhang Y, Gao X, Liu Y, Shi F, Liu J, Sun L. The prognostic valueof a derived neutrophil-lymphocyte ratio in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211034579. doi: 10.1177/10760296211034579. PMID: 34286626; PMCID: PMC8299898.
Authors
Eleonora A. Safronova
Federal State Budgetary Educational Institution of Higher Education «South-Ural State Medical University» of the Ministry of Healthcare of the Russian Federation
Candidate of Medical Sciences, Associate Professor
Associate Professor of the Department of Polyclinic Therapy and Clinical Pharmacology
safronovaeleonora68@gmail.com
Chelyabinsk, Russian Federation
Liana V. Ryabova
Federal State Budgetary Educational Institution of Higher Education «South-Ural State Medical University» of the Ministry of Healthcare of the Russian Federation
Doctor of Medical Sciences
Professor of the Department of Life Safety, Disaster Medicine, Emergency Medicine
Chelyabinsk, Russian Federation
Alexander V. Zurochka
Institute of Immunology and Physiology of the Ural Branch of the Russian Academy of Sciences
Doctor of Medical Sciences, Professor
Leading Researcher of the Laboratory of Inflammation Immunology
Yekaterinburg, Russian Federation