Mayer Otto, Bílková Simona, Nezbedová Tereza, Karnosová Petra, Windrichová Jindra, Hirmerová Jana, Pazdiora Petr, Filipovský Jan
2nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czechia.
Biomedical Center, Medical Faculty of Charles University, Pilsen, Czechia.
Med Princ Pract. 2025 May 21:1-12. doi: 10.1159/000546399.
The overexpression of plasminogen activator inhibitor-1 (PAI-1) was frequently observed during coronavirus disease 2019 (COVID-19), and it was found to be closely associated with disease severity. We have analyzed the PAI-1 status in fully recovered post-COVID patients.
In a case-control and cross-sectional study, we compared 377 patients, 30-210 days after PCR-verified COVID-19 and 884 COVID-naive controls.
Post-COVID patients ("cases") showed significantly higher plasma PAI-1 concentrations than COVID-naive controls. This difference remained significant even after complex adjustment by multiple regression. On the other hand, since the strongest covariate of increased PAI-1 was antihypertensive treatment, the difference between cases and controls in those who were on antihypertensives completely disappeared. In the subgroup of post-COVID patients only, we also found that highly symptomatic patients or those who required hospitalization in the acute phase showed significantly higher PAI-1 than patients with only mild symptoms of the disease. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1.
Increased values of PAI-1 can persist for several months after complete recovery from COVID-19 (namely, by β variant of the virus), and their expression also corresponded to clinical course of the disease.
在2019冠状病毒病（COVID-19）期间经常观察到纤溶酶原激活物抑制剂-1（PAI-1）的过表达，并且发现它与疾病严重程度密切相关。我们分析了COVID-19康复患者的PAI-1状态。
在一项病例对照和横断面研究中，我们比较了377例经PCR验证的COVID-19感染后30至210天的患者和884例未感染COVID-19的对照者。
COVID-19康复患者（“病例”）的血浆PAI-1浓度显著高于未感染COVID-19的对照者。即使经过多元回归的复杂调整，这种差异仍然显著。另一方面，由于PAI-1升高的最强协变量是抗高血压治疗，因此在接受抗高血压治疗的患者中，病例组和对照组之间的差异完全消失。仅在COVID-19康复患者亚组中，我们还发现，急性期有高度症状或需要住院治疗的患者的PAI-1显著高于仅患有轻度疾病症状的患者。同样，β突变的存在增加了COVID-19康复后PAI-1高浓度的相对风险（约11倍）。同样，β突变的存在增加了COVID-19康复后PAI-1高浓度的相对风险（约11倍）。
从COVID-19完全康复后（即感染病毒的β变体），PAI-1值升高可能持续数月，并且其表达也与疾病的临床病程相对应。
