Inflammatory markers in patients who presented with acute coronary syndrome and history of COVID-19 infection: a cross-sectional study

Abstract

Background: During the COVID-19 outbreak, the number of patients who have developed acute coronary syndromes (ACS) has soared rapidly, cardiovascular disease and mortality are influenced by the elevated inflammatory biomarkers. The aim of this study is to compare inflammatory markers between patients with ACS who hadn’t previously had COVID-19 and those who’d be infected within the preceding three months; as well as, evaluating the effect of statins on inflammatory biomarkers. Methods: This is a comparative cross-sectional study of 42 patients who presented with ACS and had previously had COVID-19 and 48 patient who had never had COVID-19, who were admitted to the coronary care unit at the Iraqi Center for Heart Disease and Baghdad Teaching Hospital, Iraq. Inflammatory biomarkers (TNF-α, IL-6, and HS-CRP) levels were determined in serum samples of all patients at admission to these centers then one month later, after administration of statins daily using the Sandwich-ELISA Principle, and Immunofluorescence technique for these markers. Result: The baseline for patients who had ACS and COVID-19 three months previously, were IL6 (85.87 ±45.80), HS-CRP (23.19 ± 14.49), and TNF-α (161.94± 240.96) were higher than patients that had ACS but not COVID-19; IL6 (50.77±22.48), HS-CRP (13.64± 12.09), and TNF-α (117.73 ±71.23),(p<0.0001), (p=0.003) and (p=0.201) for IL6, HS-CRP, and TNF-α respectively. Rosuvastatin showed a significant reduction in HS-CRP and IL6 (P<0.001), while Atorvastatin a significant reduction in HS-CRP (P<0.001) after one month of therapy. Yet there was no significant difference in the level of TNF α in these two groups at the end of this study. Conclusions: The patients with previous COVID-19 still had higher inflammatory markers than those who didn’t. Rosuvastatin 40mg had a more reduction in IL6 than Atorvastatin 40mg after one month and both of them could reduce HS-CRP, but neither could reduce TNF-α in this short period.