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Vol. 24, Art. 67 (pp. 988-999)    |    2023       

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Expression of cd68-positive cells in myocardium in postacute coronavirus syndrome

Makarov I.A., Papko K.A., Makarova T.A., Karonova T.L., Mitrofanova L.B.

Federal State Budgetary Institution "National Medical Research Center named after V.A. Almazov" of the Ministry of Health of Russia, St. Petersburg

Brief summary

Post-acute coronavirus syndrome is a symptom complex characterized by the persistence of persistent neurological, respiratory and/or cardiovascular symptoms after 1 month from the onset of acute SARS-CoV-2 infection, which lasts at least 2 months and cannot be caused by any other disease. The literature describes an increase in the number of CD68+ cells in the interstitial tissue of the myocardium in the acute period of coronavirus infection, however, data on the number of myocardial macrophages in the post-acute period of coronavirus infection are insufficient. The aim of this study was to evaluate the number of CD68-positive macrophages in the myocardium of patients in the post-COVID period. Materials and methods. A retrospective study of endomyocardial biopsies (EMBs) included 26 biopsies of patients with myocarditis and 9 patients without myocarditis with post-acute coronavirus syndrome; 33 biopsies of patients with myocarditis and 8 patients without myocarditis examined at the Center until 2019. When analyzing EMB, we performed a standard histological and immunohistochemical study of the myocardium with antibodies to CD68, HLA-DR, and VEGF. Results. When analyzing the data obtained, it was found that the number of CD68-positive macrophages is significantly higher in patients in the post-acute period of coronavirus infection compared to patients who did not tolerate coronavirus infection. When assessing the expression of HLA-DR and VEGF in 2 cases, we revealed the predominance of VEGF+macrophages in the myocardial stroma over HLA-DR+macrophages. Conclusion. One of the morphological manifestations of the post-acute period of coronavirus infection is an increase in the number of CD68+ macrophages per 1 mm2 of myocardium. The persistence of symptoms of cardiac pathology may be associated with a local cytokine imbalance in the myocardial tissue due to an increased content of activated M1 and M2 macrophages. Additional studies are required to confirm this hypothesis.


Key words

endomyocardial biopsies, post-acute coronavirus syndrome, myocarditis, immunohistochemistry, macrophage

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