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Cardiac Fibrosis Is a Risk Factor for Severe COVID-19
Increased left ventricular fibrosis has been reported in patients hospitalized with coronavirus disease 2019 (COVID-19). It is unclear whether this fibrosis is a consequence of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection or a risk factor for severe disease progression...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569622/ https://www.ncbi.nlm.nih.gov/pubmed/34745111 http://dx.doi.org/10.3389/fimmu.2021.740260 |
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author | Mustroph, Julian Hupf, Julian Baier, Maria J. Evert, Katja Brochhausen, Christoph Broeker, Katharina Meindl, Christine Seither, Benedikt Jungbauer, Carsten Evert, Matthias Maier, Lars S. Wagner, Stefan |
author_facet | Mustroph, Julian Hupf, Julian Baier, Maria J. Evert, Katja Brochhausen, Christoph Broeker, Katharina Meindl, Christine Seither, Benedikt Jungbauer, Carsten Evert, Matthias Maier, Lars S. Wagner, Stefan |
author_sort | Mustroph, Julian |
collection | PubMed |
description | Increased left ventricular fibrosis has been reported in patients hospitalized with coronavirus disease 2019 (COVID-19). It is unclear whether this fibrosis is a consequence of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection or a risk factor for severe disease progression. We observed increased fibrosis in the left ventricular myocardium of deceased COVID-19 patients, compared with matched controls. We also detected increased mRNA levels of soluble interleukin-1 receptor-like 1 (sIL1-RL1) and transforming growth factor β1 (TGF-β1) in the left ventricular myocardium of deceased COVID-19 patients. Biochemical analysis of blood sampled from patients admitted to the emergency department (ED) with COVID-19 revealed highly elevated levels of TGF-β1 mRNA in these patients compared to controls. Left ventricular strain measured by echocardiography as a marker of pre-existing cardiac fibrosis correlated strongly with blood TGF-β1 mRNA levels and predicted disease severity in COVID-19 patients. In the left ventricular myocardium and lungs of COVID-19 patients, we found increased neuropilin-1 (NRP-1) RNA levels, which correlated strongly with the prevalence of pulmonary SARS-CoV-2 nucleocapsid. Cardiac and pulmonary fibrosis may therefore predispose these patients to increased cellular viral entry in the lung, which may explain the worse clinical outcome observed in our cohort. Our study demonstrates that patients at risk of clinical deterioration can be identified early by echocardiographic strain analysis and quantification of blood TGF-β1 mRNA performed at the time of first medical contact. |
format | Online Article Text |
id | pubmed-8569622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85696222021-11-06 Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 Mustroph, Julian Hupf, Julian Baier, Maria J. Evert, Katja Brochhausen, Christoph Broeker, Katharina Meindl, Christine Seither, Benedikt Jungbauer, Carsten Evert, Matthias Maier, Lars S. Wagner, Stefan Front Immunol Immunology Increased left ventricular fibrosis has been reported in patients hospitalized with coronavirus disease 2019 (COVID-19). It is unclear whether this fibrosis is a consequence of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection or a risk factor for severe disease progression. We observed increased fibrosis in the left ventricular myocardium of deceased COVID-19 patients, compared with matched controls. We also detected increased mRNA levels of soluble interleukin-1 receptor-like 1 (sIL1-RL1) and transforming growth factor β1 (TGF-β1) in the left ventricular myocardium of deceased COVID-19 patients. Biochemical analysis of blood sampled from patients admitted to the emergency department (ED) with COVID-19 revealed highly elevated levels of TGF-β1 mRNA in these patients compared to controls. Left ventricular strain measured by echocardiography as a marker of pre-existing cardiac fibrosis correlated strongly with blood TGF-β1 mRNA levels and predicted disease severity in COVID-19 patients. In the left ventricular myocardium and lungs of COVID-19 patients, we found increased neuropilin-1 (NRP-1) RNA levels, which correlated strongly with the prevalence of pulmonary SARS-CoV-2 nucleocapsid. Cardiac and pulmonary fibrosis may therefore predispose these patients to increased cellular viral entry in the lung, which may explain the worse clinical outcome observed in our cohort. Our study demonstrates that patients at risk of clinical deterioration can be identified early by echocardiographic strain analysis and quantification of blood TGF-β1 mRNA performed at the time of first medical contact. Frontiers Media S.A. 2021-10-22 /pmc/articles/PMC8569622/ /pubmed/34745111 http://dx.doi.org/10.3389/fimmu.2021.740260 Text en Copyright © 2021 Mustroph, Hupf, Baier, Evert, Brochhausen, Broeker, Meindl, Seither, Jungbauer, Evert, Maier and Wagner https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Mustroph, Julian Hupf, Julian Baier, Maria J. Evert, Katja Brochhausen, Christoph Broeker, Katharina Meindl, Christine Seither, Benedikt Jungbauer, Carsten Evert, Matthias Maier, Lars S. Wagner, Stefan Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title | Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title_full | Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title_fullStr | Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title_full_unstemmed | Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title_short | Cardiac Fibrosis Is a Risk Factor for Severe COVID-19 |
title_sort | cardiac fibrosis is a risk factor for severe covid-19 |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569622/ https://www.ncbi.nlm.nih.gov/pubmed/34745111 http://dx.doi.org/10.3389/fimmu.2021.740260 |
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