Clinical study of plasma lymphocyte subsets and inflammatory factors in patients with acute coronary syndrome after COVID-19(omicron variant)infection

Abstract Background: The Omicron variant is the main circulating strain by the end of 2022,our study is to reveal the possible impact of COVID-19(Omicron variant) infection on ACS patients Through researching the changes of lymphocyte subsets and inflammatory factors. Methods: This is a case-control study. 234 patients of COVID-19 infection accompany with acute coronary syndrome were enrolled,78 patients with only COVID-19 infection were enrolled as controls. Flow cytometry was used to detect lymphocyte subsets, Chemiluminescence assay was used to measure IL-6, IL-8, and TNF-α levels. The above indexes were compared in three groups during different stage of COVID-19 infection. Results: 1) Compared with the control group,after COVID-19 infection,the STEMI and NSTE-ACS groups both showed a decrease in CD4+ T lymphocytes，while an increase in IL-6 and TNF-α levels only in STEMI group (P<0.05); Furtherly Within 3 months of COVID-19 infection,the STEMI group showed a decrease in CD4+ and CD8+ T lymphocytes, and an increase in CD4+/CD8+, IL-6, and TNF-α (P<0.05), while only CD4+ T decreased in the NSTE-ACS group (P<0.05); But after 3 months of COVID-19 infection, only the STEMI group showed a significant increase in IL-6 and TNF-α (P<0.05).2)Compared with the NSTE-ACS group, the STEMI group showed a significant decrease in CD8+ T lymphocytes and an increase in CD4+/CD8+ T lymphocytes within 3 months of COVID-19 infection(P<0.05) Conclusions: Patients with a decrease in CD4+ T lymphocytes after COVID-19 infection maybe more prone to combined withacute coronary syndrome. Patients who develop STEMI within 3 months of COVID-19 infection may have a poorer prognosis.