Li Xueqin, Tian Yaxin, Cao Hongyan, Cheng Jinfang
Department of Laboratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China.
BMC Infect Dis. 2025 Apr 7;25(1):471. doi: 10.1186/s12879-025-10849-y.
As the coronavirus disease-2019 (COVID-19) pandemic persists, post-COVID-19 syndrome (PS), characterized by symptoms like chest pain, fatigue, and palpitations, is becoming a significant medical and social issue. COVID-19 patients with existing coronary artery disease (CAD) may face higher risks of complications. It is crucial to assess if PS patients also have CAD, though data is limited.
We studied 75 COVID-19 patients and 68 non-COVID-19 patients admitted to our hospital between 2022/12/20 to 2023/01/20. Demographic, laboratory, and clinical data were collected upon admission. The Gensini score (GS) was used to assess coronary atherosclerosis severity. Patients were categorized by GS and clinical traits to identify potential independent risks linked to CAD and COVID-19 severity.
COVID-19 patients with existing CAD had higher levels of serum soluble growth stimulation expression of gene 2 protein (sST2), myeloperoxidase, ALT, AST, PT, B-type natriuretic peptide (BNP), and hypersensitive troponin-I (hs-cTnI), along with longer hospital stays, more ICU admissions, and increased heart failure and ACS morbidity compared to those without CAD. Univariate and multivariate analysis identified sST2 as an independent risk factor for COVID-19 patients with coexisting CAD (odds ratio 1.122). sST2 levels were positively correlated with coronary angiography GS (r = 0.474, p < 0.001) in COVID-19 patients and were significantly higher in cases with GS ≥ 32, regardless of COVID-19 status (p < 0.001) and specifically in COVID-19 patients (p = 0.006). ROC analysis showed sST2 predicted ICU admission, hospital stay duration, and morbidity of HF and ACS similarly to GS.
Admission serum sST2 levels should be considered in COVID-19 patients with CAD-like symptoms for treatment planning and could serve as a prognostic biomarker for COVID-19 with co-existing CAD in clinical practice.
随着2019冠状病毒病（COVID-19）大流行持续，以胸痛、疲劳和心悸等症状为特征的COVID-19后综合征（PS）正成为一个重大的医学和社会问题。患有冠状动脉疾病（CAD）的COVID-19患者可能面临更高的并发症风险。尽管数据有限，但评估PS患者是否也患有CAD至关重要。
我们研究了2022年12月20日至2023年1月20日期间我院收治的75例COVID-19患者和68例非COVID-19患者。入院时收集人口统计学、实验室和临床数据。采用Gensini评分（GS）评估冠状动脉粥样硬化严重程度。根据GS和临床特征对患者进行分类，以确定与CAD和COVID-19严重程度相关的潜在独立风险。
与无CAD的COVID-19患者相比，患有CAD的COVID-19患者血清可溶性生长刺激基因2蛋白（sST2）、髓过氧化物酶、谷丙转氨酶、谷草转氨酶、凝血酶原时间、B型利钠肽（BNP）和超敏肌钙蛋白I（hs-cTnI）水平更高，住院时间更长，入住重症监护病房的次数更多，心力衰竭和急性冠状动脉综合征（ACS）发病率增加。单因素和多因素分析确定sST2是合并CAD的COVID-19患者的独立危险因素（比值比1.122）。在COVID-19患者中，sST2水平与冠状动脉造影GS呈正相关（r = 0.474，p < 0.001），在GS≥32的病例中显著更高，无论COVID-19状态如何（p < 0.001），在COVID-19患者中尤为明显（p = 0.006）。ROC分析显示，sST2预测重症监护病房入住、住院时间以及心力衰竭和ACS发病率的能力与GS相似。
对于有CAD样症状的COVID-19患者，在制定治疗计划时应考虑入院时血清sST2水平，并且在临床实践中，sST2可作为合并CAD的COVID-19的预后生物标志物。
