Association of heart failure symptoms in post-COVID syndrome with impaired monocytic bioenergetic profile

https://doi.org/10.1007/s00392-024-02526-y

Dilvin Semo (Münster)1, Z. Shomanova (Münster)2, J. Sindermann (Münster)2, H. Reinecke (Münster)1, R. Godfrey (Münster)1, R. Pistulli (Münster)1

1Universitätsklinikum Münster Klinik für Kardiologie I: Koronare Herzkrankheit, Herzinsuffizienz und Angiologie Münster, Deutschland; 2Universitätsklinikum Münster Interdisziplinäre Sektion Herzinsuffizienz Münster, Deutschland

 

Introduction:
Post-COVID syndrome appears with symptoms such as dyspnea and angina pectoris after COVID-19 diseases. Recent studies associated post-COVID with elevated cellular oxidative stress. Due to unclear impact of post-COVID on monocytic function, we investigated mitochondrial function and oxidative stress properties in monocytes of post-COVID patients.  

Methods:

Patients, which have been diagnosed with post-COVID syndrome (n=14) were recruited and matched with unaffected controls (n=10) for age, sex and cardiovascular risk factors. Cardiac diseases were excluded through cardiac work-up (echocardiography, functional stress testing and when necessary coronary angiography) in symptomatic patients. CD14++ monocytes were isolated using negative selection method. The bioenergetic status of the monocytes was investigated using the Agilent Seahorse XF Cell Mito Stress Test without and after modulation of reactive oxygen species (ROS) by buthionine sulfoximine (BSO).  

Results:
Primary monocytes isolated from post-COVID patients showed an enhanced basal proton leak (p=0.57), reduced maximal respiration and reserved respiratory capacity (p=0.19) compared to controls. Induction of additional oxidative stress by ROS modulation revealed a significantly impaired bioenergetic profile of monocytes. Reduction of basal respiration (3-fold, p=0.0005), maximal respiration (4-fold, p=0.004) and spare respiratory capacity (5-fold, p=0.008) could be found.   Conclusions: Our study revealed an impaired bioenergetic profile of CD14++ monocytic mitochondria in patients suffering post-COVID syndrome. Whether these findings provide a novel biomarker for measuring systemic oxidative stress conditions or whether there is a direct association of post-COVID disease and monocytic function needs to be addressed in further studies.

 

Demographic and Baseline Clinical Characteristics

 

Characteristic

Post-COVID
(N=14)

Control
(N=10)

Overall

Age – yr (±SD)

54 (±16)

        53 (±16)

54 (±16)

Male sex – no. (%)

8 (57.1)

5 (50.0)

13 (54.2)

Smoking -  no. (%)

8 (57.1)

3 (30.0)

11 (45.6)

Diabetes - no. (%)

0 (0)

0 (0)

0 (0)

Dyslipidemia - no. (%)

6 (42.9)

3 (30.0)

9 (37.5)

Hypertension

8 (57.1)

5 (50.0)

13 (54.2)

Family history of CV-disease - no. (%)

7 (50)

4 (40.0)

11 (45.6)

Dyspnoea - no. (%)

13 (92.9)

0 (0.0)

13 (54.2)

Angina pectoris - no. (%)

7 (50)

0 (0.0)

7 (29.2)

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