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

Biomarkers. 2023 Feb;28(1):97-110. doi: 10.1080/1354750X.2022.2148745. Epub 2022 Nov 23.


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

Material and methods: 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.

Results: 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.

Discussion: 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.

Conclusion: 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.

Keywords: SARS-CoV-2 infection; hyperinflammation; monocytes; platelets; recovery.

MeSH terms

  • COVID-19*
  • Chemokines
  • Cytokines
  • Humans
  • Monocytes
  • SARS-CoV-2


  • Cytokines
  • Chemokines