Impact of Anticytokine Therapy on Acute Phase of Novel Coronavirus Infection on Ischemic Heart Disease

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Abstract

BACKGROUND: Recent studies showed a causal relationship between inflammation and atherogenesis with underlying ischemic heart disease. A novel coronavirus infection has been found to trigger a cytokine storm. Various anticytokine therapies have been used for the treatment. However, the impact of these interventions on ischemic heart disease remains unclear.

AIM: This study aimed to assess the impact of various anticytokine treatments initiated in the acute phase of novel coronavirus infection on ischemic heart disease post-COVID.

METHODS: The study included 272 patients with a history of ischemic heart disease. The patients had received various anticytokine therapies for novel coronavirus infection. They were followed up after recovering from novel coronavirus infection. The patients were stratified into two groups based on worsening of underlying ischemic heart disease (worsening vs no worsening).

RESULTS: The worsening of ischemic heart disease was significantly associated with novel coronavirus infection severity (χ2df = 2 = 28.406; p < 0.0001) and sex (in males, χ2df = 1 = 7.310; p = 0.007). Patients who had severe novel coronavirus infection and received combination anticytokine therapy in the acute phase of the infection were less likely to experience worsening of ischemic heart disease compared to those who received monotherapy for cytokine storm (p1,4 = 0.016; p3,4 = 0.024). A proposed model with a 68.8% accuracy rate estimates the worsening probability of ischemic heart disease after novel coronavirus infection using several factors, including sex, age, severity of symptoms, and concurrent treatment.

CONCLUSION: The findings indicate that inflammation plays a crucial role in ischemic heart disease and that the severity of novel coronavirus infection has a significant impact on its clinical course. Combination treatment for the cytokine storm that is associated with novel coronavirus infection in patients with underlying ischemic heart disease is correlated with better prognosis.

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About the authors

Ruslan I. Litvinenko

Kirov Military Medical Academy

Author for correspondence.
Email: vmeda-nio@mil.ru
ORCID iD: 0000-0001-8435-9958
SPIN-code: 8981-4000

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Evgeny V. Kryukov

Kirov Military Medical Academy

Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-8396-1936
SPIN-code: 3900-3441

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Arkady V. Yazenok

Kirov Military Medical Academy

Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-1334-8191
SPIN-code: 4107-1280

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg

Sergey V. Gaiduk

Kirov Military Medical Academy

Email: gaiduksergey@mail.ru
ORCID iD: 0000-0003-1524-9493
SPIN-code: 8602-4922

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg

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2. Fig. 1. Chronological sequence of the stages of the conducted research.

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3. Fig. 2. ROC curve of the binary logistic regression model.

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