Local Inflammation May Underlie Cardiac Damage in Post-COVID-19 Period

Abstract

Background

Some patients experience subclinical cardiovascular dysfunction after COVID-19, possibly driven by persistent inflammatory mechanisms that remain incompletely understood. NT-proBNP and GDF-15 have been proposed as biomarkers of myocardial stress and inflammation in this context.

Objectives

To investigate associations between NT-proBNP, GDF-15, inflammatory cytokines, and echocardiographic parameters in patients with Post-COVID-19 Condition (PCC).

Methods

This cross-sectional study included 78 adults followed in a university hospital cohort. Participants were stratified into elevated NT-proBNP (n = 39) and normal NT-proBNP (n = 39) groups. Clinical, laboratory, and echocardiographic variables were assessed, including PALS and RV-GLS. Serum GDF-15 and cytokines were quantified using a multiplex bead assay. ROC curve analysis evaluated the predictive value of GDF-15 for elevated NT-proBNP.

Results

Participants with elevated NT-proBNP had reduced PALS (28.5% vs. 36.7%; p < 0.05), and higher GDF-15 (median 368 vs. 219 pg/mL) and IL-1β levels (2.47 vs. 0.94 pg/mL; p < 0.05). GDF-15 ≥ 519 pg/mL predicted elevated NT-proBNP (AUC = 0.65). Individuals with elevated GDF-15 also showed worse RV-GLS (20.2% vs. 26.9%; p < 0.05) and higher IL-8 levels (p < 0.05).

Conclusions

NT-proBNP, GDF-15, and IL-1β identify subclinical myocardial dysfunction in PCC, supporting a pathophysiological model centered on persistent inflammation and early myocardial remodeling, distinct from classic ischemic pathways.