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Cardiac inflammation and microvascular procoagulant changes are decreased in second wave compared to first wave deceased COVID-19 patients.
Wu, Linghe; Baylan, Umit; van der Leeden, Britt; Schurink, Bernadette; Roos, Eva; Schalkwijk, Casper G; Bugiani, Marianna; van der Valk, Paul; van Rossum, Albert C; Zeerleder, Sacha S; Heunks, Leo M A; Boon, Reinier A; de Boer, Onno J; van der Wal, Allard C; Niessen, Hans W M; Krijnen, Paul A J.
  • Wu L; Dept. of Pathology and Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centre (AUMC), location VUmc, De Boelelaan 1017, 1081HV Amsterdam, the Netherlands.
  • Baylan U; Dept. of Pathology and ACS, AUMC, location VUmc, the Netherlands.
  • van der Leeden B; Dept. of Pathology and Amsterdam institute for Infection and Immunity, AUMC, the Netherlands.
  • Schurink B; Dept. of Pathology, AUMC, location VUmc, the Netherlands.
  • Roos E; Dept. of Pathology, AUMC, location VUmc, the Netherlands.
  • Schalkwijk CG; Dept. of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
  • Bugiani M; Dept. of Pathology, AUMC, location VUmc and AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
  • van der Valk P; Dept. of Pathology, AUMC, location VUmc, the Netherlands.
  • van Rossum AC; Dept. of Cardiology and ACS, AUMC, location VUmc, the Netherlands.
  • Zeerleder SS; Dept. of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland; Dept. for BioMedical Research, University of Bern, Murtenstrasse 35, 3008 Bern, Switzerland.
  • Heunks LMA; Dept. Intensive Care Medicine, AUMC, location VUmc, the Netherlands.
  • Boon RA; Department of Physiology, AUMC, location VUmc, Amsterdam, the Netherlands; Institute for Cardiovascular Regeneration, Centre for Molecular Medicine and German center for Cardiovascular Research (DZHK), Goethe University, Frankfurt am Main, Germany.
  • de Boer OJ; Dept. of Pathology and ACS, AUMC, location VUmc, the Netherlands.
  • van der Wal AC; Dept. of Pathology and ACS, AUMC, location VUmc, the Netherlands.
  • Niessen HWM; Dept. of Pathology and ACS and Dept. of Cardiac Surgery, AUMC, location VUmc, the Netherlands.
  • Krijnen PAJ; Dept. of Pathology and ACS, AUMC, location VUmc, the Netherlands. Electronic address: paj.krijnen@amsterdamumc.nl.
Int J Cardiol ; 349: 157-165, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1549827
ABSTRACT

BACKGROUND:

Compelling evidence has shown cardiac involvement in COVID-19 patients. However, the overall majority of these studies use data obtained during the first wave of the pandemic, while recently differences have been reported in disease course and mortality between first- and second wave COVID-19 patients. The aim of this study was to analyze and compare cardiac pathology between first- and second wave COVID-19 patients.

METHODS:

Autopsied hearts from first- (n = 15) and second wave (n = 10) COVID-19 patients and from 18 non-COVID-19 control patients were (immuno)histochemically analyzed. CD45+ leukocyte, CD68+ macrophage and CD3+ T lymphocyte infiltration, cardiomyocyte necrosis and microvascular thrombosis were quantified. In addition, the procoagulant factors Tissue Factor (TF), Factor VII (FVII), Factor XII (FXII), the anticoagulant protein Dipeptidyl Peptidase 4 (DPP4) and the advanced glycation end-product N(ε)-Carboxymethyllysine (CML), as markers of microvascular thrombogenicity and dysfunction, were quantified.

RESULTS:

Cardiac inflammation was significantly decreased in second wave compared to first wave COVID-19 patients, predominantly related to a decrease in infiltrated lymphocytes and the occurrence of lymphocytic myocarditis. This was accompanied by significant decreases in cardiomyocyte injury and microvascular thrombosis. Moreover, microvascular deposits of FVII and CML were significantly lower in second wave compared to first wave COVID-19 patients.

CONCLUSIONS:

These results show that in our cohort of fatal COVID-19 cases cardiac inflammation, cardiomyocyte injury and microvascular thrombogenicity were markedly decreased in second wave compared to first wave patients. This may reflect advances in COVID-19 treatment related to an increased use of steroids in the second COVID-19 wave.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Limits: Humans Language: English Journal: Int J Cardiol Year: 2022 Document Type: Article Affiliation country: J.ijcard.2021.11.079

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Limits: Humans Language: English Journal: Int J Cardiol Year: 2022 Document Type: Article Affiliation country: J.ijcard.2021.11.079