Sustained Expression of Plasminogen Activator Inhibitor-1 in Patients Recovered from COVID-19 Disease
Otto Mayer1,2, Simona Bílková3,4, Tereza Nezbedová3
12nd Department of Internal Medicine, Medical Faculty of Charles University and University Hospital, Pilsen, Czechia, mayero@fnplzen.cz.
Insights
Plasminogen activator inhibitor-1 (PAI-1) levels remain elevated months after COVID-19 recovery, particularly in severe cases and with the beta variant. Antihypertensive treatment may influence these findings.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Hematology
Background:
- Plasminogen activator inhibitor-1 (PAI-1) is linked to COVID-19 severity.
- Understanding long-term PAI-1 expression post-COVID-19 is crucial.
Purpose of the Study:
- To analyze PAI-1 levels in fully recovered COVID-19 patients.
- To assess the correlation between PAI-1 and disease severity.
Main Methods:
- A case-control and cross-sectional study design.
- Comparison of 377 post-COVID-19 patients (30-210 days post-infection) with 884 COVID-naive controls.
- Multiple regression analysis to adjust for covariates.
Main Results:
- Post-COVID-19 patients exhibited significantly higher plasma PAI-1 concentrations than controls.
- The difference in PAI-1 disappeared in patients on antihypertensive treatment.
- Higher PAI-1 levels were observed in patients with severe symptoms or hospitalization during acute COVID-19.
- The beta variant of SARS-CoV-2 was associated with an approximately 11-fold increased risk of high post-COVID PAI-1.
Conclusions:
- Elevated PAI-1 can persist for months after COVID-19 recovery, especially with the beta variant.
- PAI-1 expression correlates with the clinical course of COVID-19.
- Further research into PAI-1's role in post-COVID-19 sequelae is warranted.
Abstract:
Objectives: The overexpression of plasminogen activator inhibitor-1 (PAI-1) was frequently observed during coronavirus disease 2019 (COVID-19), and it was found to be closely associated with disease severity. We have analyzed the PAI-1 status in fully recovered post-COVID patients.
Subjects And Methods:
In a case-control and cross-sectional study, we compared 377 patients, 30-210 days after PCR-verified COVID-19 and 884 COVID-naive controls.
Results:
Post-COVID patients ("cases") showed significantly higher plasma PAI-1 concentrations than COVID-naive controls. This difference remained significant even after complex adjustment by multiple regression. On the other hand, since the strongest covariate of increased PAI-1 was antihypertensive treatment, the difference between cases and controls in those who were on antihypertensives completely disappeared. In the subgroup of post-COVID patients only, we also found that highly symptomatic patients or those who required hospitalization in the acute phase showed significantly higher PAI-1 than patients with only mild symptoms of the disease. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1.
Conclusions:
Increased values of PAI-1 can persist for several months after complete recovery from COVID-19 (namely, by β variant of the virus), and their expression also corresponded to clinical course of the disease.
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