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Changing Face of Inflammatory Activation in Complex Coronary Artery Disease during the COVID-19 Pandemic
Tomasz Urbanowicz1, Paweł Czub2, Anna Olasińska-Wiśniewska1
1Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Insights
The COVID-19 pandemic increased inflammatory markers in patients undergoing surgical revascularization. However, this immune activation did not impact one-year mortality rates after the procedure.
Area of Science:
- Immunology
- Cardiovascular Surgery
- Epidemiology
Background:
- The COVID-19 pandemic has altered population immunological status, leading to increased inflammatory responses.
- Assessing changes in inflammatory markers in surgical patients is crucial for understanding pandemic-related health impacts.
Purpose of the Study:
- To compare the degree of inflammatory activation in patients undergoing surgical revascularization before and during the COVID-19 pandemic.
- To evaluate the impact of pandemic-related immune changes on surgical outcomes.
Main Methods:
- Retrospective analysis of 533 patients undergoing surgical revascularization (343 pre-pandemic, 190 during pandemic).
- Inflammatory markers assessed via whole blood counts.
- Propensity score matching used to create comparable groups (190 patients each).
Main Results:
- Patients during the COVID-19 pandemic showed significantly higher preoperative monocyte count, monocyte-to-lymphocyte ratio, and systemic inflammatory response index.
- Perioperative mortality rates were 1% in both groups.
- 12-month mortality rates were comparable (5.6% pre-COVID vs. 7% during-COVID).
Conclusions:
- Whole blood analysis reveals increased inflammatory activation in patients with complex coronary artery disease during the COVID-19 pandemic.
- Despite immune variations, one-year mortality after surgical revascularization remained unaffected.
Introduction:
The COVID-19 pandemic has changed the immunological status of the population, indicating increased activation. The aim of the study was to compare the degree of inflammatory activation in patients admitted for surgical revascularization in the period before and during the COVID-19 pandemic.
Materials And Methods:
This retrospective analysis included an analysis of inflammatory activation assessed on the basis of whole blood counts in 533 patients (435 (82%) male and 98 (18%) female) with a median age of 66 (61-71) years who underwent surgical revascularization, including 343 and 190 patients operated on in 2018 and 2022, respectively.
Results:
The compared groups were matched by propensity score matching analysis, obtaining 190 patients in each group. Significantly higher values of preoperative monocyte count (p = 0.015), monocyte-to-lymphocyte ratio (p = 0.004) and systemic inflammatory response index (p = 0.022) were found in the during-COVID subgroup. The perioperative and 12-month mortality rates were comparable, with 1% (n = 4) in 2018 vs. 1% (n = 2) in 2022 (p = 0.911), and 5.6 % (n = 11 patients) vs. 7% (n = 13 patients) (p = 0.413), in the pre-COVID and during-COVID subgroups, respectively.
Conclusions:
Simple whole blood analysis in patients with complex coronary artery disease performed before and during the COVID-19 pandemic indicates excessive inflammatory activation. However, the immune variation did not interfere with one-year mortality rate after surgical revascularization.
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