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

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 (p_1,4 = 0.016; p_3,4 = 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.

Keywords

novel coronavirus infection / ischemic heart disease / cytokine storm / combination anticytokine therapy / glucocorticoids / interleukin 6 inhibitors / Janus kinase inhibitors

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