Immunological and biochemical markers of adverse disease outcomes in COVID-19 and chronic heart failure

Mordyk A.V., Bagisheva N.V., Moiseeva M.V., Streltsova V.V., Antipova E.P.

Omsk State Medical University, Omsk, Belarus
National Medical Research Center for Phthisiopulmonology and Infectious Diseases, Moscow, Russia

The purpose of this study was to study immunological and biochemical markers of unfavorable outcome during coronavirus infection in patients with chronic heart failure.
Materials and methods. The retrospective study included 136 patients with COVID-19, 46 of whom had chronic heart failure (CHF). All of them underwent a study of C-reactive protein (CRP) of interleukin-6 (IL-6) with assessment of the level of increase in markers (IgM, IgG to SARS-CoV-2) with an assessment of the outcome of the disease. Of these, 70 were men (24 with CHF), 66 women (22 with CHF). Median age of patients with COVID-19 48 (39; 56) years, patients with COVID-19 and CHF 58 (52; 62) years
Research results. In patients with COVID-19+CHF (group 1) hospitalized, there was a less pronounced increase in IgM to SARS-CoV-2, higher IgG to SARS-CoV-2 both initially and after 8-10 days, a parallel increase in both CRP and IL-6 unlike patients with only COVID-19 without CHF (group 2). Statistically significant differences in IgM levels to SARS-CoV-2 were revealed in patients of groups 1 and 2 with a favorable outcome. The level of CRP and IL-6 in deceased patients was higher and did not tend to decrease; the changes were more pronounced in group 1. Thus, a simultaneous increase in CRP and IL-6 in patients with COVID-19 and CHF is an unfavorable prognostic parameter for patient survival. Prolongation of antibody titers, both IgM and IgG, can be considered as markers of antibody-dependent increase in infection.