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Recovery of systemic hyperinflammation in patients with severe SARS-CoV-2 infection

posted on 24.11.2022, 06:40 authored by Carolin Langnau, Henrik Janing, Hüseyin Kocaman, Sarah Gekeler, Manina Günter, Álvaro Petersen-Uribe, Philippa Jaeger, Barbara Koch, Klaus-Peter Kreisselmeier, Tatsiana Castor, Dominik Rath, Meinrad Paul Gawaz, Stella E. Autenrieth, Karin Anne Lydia Mueller

Patients with cardiovascular disease (CVD) and acute SARS-CoV-2 infection might show an altered immune response during COVID-19.

Twenty-three patients with CVD and SARS-CoV-2 infection were prospectively enrolled and received a cardiological assessment at study entry and during follow-up visit. Inclusion criteria of our study were age older than 18 years, presence of CVD, and acute SARS-CoV-2 infection. The median age of the patient cohort was 69 (IQR 55–79) years. 12 (52.2%) patients were men. Peripheral monocytes and chemokine/cytokine profiles were analysed.

Numbers of classical and non-classical monocytes were significantly decreased during acute SARS-CoV-2 infection compared to 3-month recovery. While classical monocytes reached the expected level in peripheral blood after 3 months, the number of non-classical monocytes remained significantly reduced.

All three monocyte subsets exhibited changes of established adhesion and activation markers. Interestingly, they also expressed higher levels of pro-inflammatory cytokines like macrophage migration inhibitory factor (MIF) at the time of recovery, although MIF was only slightly increased during the acute phase.

Changes of monocyte phenotypes and increased MIF expression after 3-month recovery from acute SARS-CoV-2 infection may indicate persistent, possibly long-lasting, pro-inflammatory monocyte function in CVD patients.


This work was supported by the German Research Foundation (DFG) – Project number 374031971–TRR 240 and by the Ministry of Science, Research and the Arts of the State of Baden-Württemberg (COVID-19 Funding) grant to Meinrad Paul Gawaz. The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript.