Role of antibodies, inflammatory markers, and echocardiographic findings in postacute cardiopulmonary symptoms after SARS-CoV-2 infection
Matthew S. Durstenfeld, … , Steven G. Deeks, Priscilla Y. Hsue
Matthew S. Durstenfeld, … , Steven G. Deeks, Priscilla Y. Hsue
Published April 7, 2022
Citation Information: JCI Insight. 2022;7(10):e157053. https://doi.org/10.1172/jci.insight.157053.
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Research Article COVID-19 Cardiology

Role of antibodies, inflammatory markers, and echocardiographic findings in postacute cardiopulmonary symptoms after SARS-CoV-2 infection

Abstract

Shortness of breath, chest pain, and palpitations occur as postacute sequelae of COVID-19, but whether symptoms are associated with echocardiographic abnormalities, cardiac biomarkers, or markers of systemic inflammation remains unknown. In a cross-sectional analysis, we assessed symptoms, performed echocardiograms, and measured biomarkers among adults more than 8 weeks after confirmed SARS-CoV-2 infection. We modeled associations between symptoms and baseline characteristics, echocardiographic findings, and biomarkers using logistic regression. We enrolled 102 participants at a median of 7.2 months following COVID-19 onset; 47 individuals reported dyspnea, chest pain, or palpitations. Median age was 52 years, and 41% of participants were women. Female sex, hospitalization, IgG antibody against SARS-CoV-2 receptor binding domain, and C-reactive protein were associated with symptoms. Regarding echocardiographic findings, 4 of 47 participants (9%) with symptoms had pericardial effusions compared with 0 of 55 participants without symptoms; those with effusions had a median of 4 symptoms compared with a median of 1 symptom in those without effusions. There was no strong evidence for a relationship between symptoms and echocardiographic functional parameters or other biomarkers. Among adults more than 8 weeks after SARS-CoV-2 infection, SARS-CoV-2 RBD antibodies, markers of inflammation, and, possibly, pericardial effusions are associated with cardiopulmonary symptoms. Investigation into inflammation as a mechanism underlying postacute sequelae of COVID-19 is warranted.

Authors

Matthew S. Durstenfeld, Michael J. Peluso, J. Daniel Kelly, Sithu Win, Shreya Swaminathan, Danny Li, Victor M. Arechiga, Victor Zepeda, Kaiwen Sun, Shirley Shao, Christopher Hill, Mireya I. Arreguin, Scott Lu, Rebecca Hoh, Viva Tai, Ahmed Chenna, Brandon C. Yee, John W. Winslow, Christos J. Petropoulos, John Kornak, Timothy J. Henrich, Jeffrey N. Martin, Steven G. Deeks, Priscilla Y. Hsue

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Figure 3

Biomarkers by presence of cardiopulmonary symptoms.

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Biomarkers by presence of cardiopulmonary symptoms. Box-and-whisker plot...
Box-and-whisker plots of biomarkers plotted on log scale by presence of cardiopulmonary symptoms (no symptoms in blue on the left for each plot, symptoms in pink on the right), including hs-troponin I (n = 95), NT-pro-BNP (n = 87), hsCRP (n = 95), IL-6 (n = 73), IL-10 (n = 73), IFN-γ (n = 69), TNF-α (n = 73), and SARS-CoV-2 receptor binding domain IgG antibodies (n = 73), with P values listed for unadjusted t tests of log-transformed markers. The adjusted odds of having dyspnea, chest pain, or palpitations were 1.32 times higher per doubling of hsCRP (95% CI, 1.01–1.73; P = 0.02) and 1.42 times higher per doubling of antibody levels (95% CI, 1.06–1.90; P = 0.02). Other biomarkers were not strongly associated with symptoms. Boxes represent the 25th and 75th percentile, lines inside the boxes represent medians, whiskers represent the upper and lower adjacent values (3/2 times the IQR from the end of the box) as defined by Tukey, and dots represent outliers outside the whiskers.