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May 8, 2026European Stroke Journal0 citationsOpen Access

Abstract Number: Esoc2026a1641 Post-Covid-19 Atrial Fibrillation: Immune Dysregulation and Implications for Stroke Risk

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OSOksana StasyshenaOSOleg SychovTTTatiana Talaieva

Key Result

Post-COVID-19 atrial fibrillation progression was associated with significantly lower T-helper cell levels compared to stable post-COVID AF (39.7% vs 46.9%, p<0.05).

Key Points

  • This research investigates the immune alterations associated with atrial fibrillation (AF) in patients recovering from COVID-19.
  • Included 165 patients with AF, divided into groups based on post-COVID changes
  • Analyzed lymphocyte and monocyte subpopulations using flow cytometry
  • Compared immune parameters between post-COVID AF patients and a control group.
  • G2 (AF progression) had lower T-helper cells compared to G3 (stable AF) (39.7% vs 46.9%, p<0.05)
  • G2 had 67.3% higher CD3+CD8+ cytotoxic T lymphocytes than G3 (p<0.05)
  • B-lymphocyte levels were lower in G2 compared to control (8.47% vs 10.4%, p<0.005)

Study Design

Type

Observational (n=165)

Structured PICO

Are there differences in immune cell subpopulations among patients with post-COVID-19 atrial fibrillation compared to those without a history of COVID-19?

P
Population
165 patients with atrial fibrillation (mean age 62.5 ± 0.9 years, 47% men), including 116 with post-COVID-19 AF (36 new-onset, 25 progression, 55 stable) and 49 controls with AF but no history of COVID-19.
C
Comparator
Patients with atrial fibrillation without a history of COVID-19
O
Outcome
Lymphocyte and monocyte subpopulations in peripheral blood measured using flow cytometrysurrogate

Post-COVID-19 atrial fibrillation progression is associated with specific immune alterations, including reduced T-helper cells and elevated cytotoxic T cells and non-classical monocytes.

Main Result

Absolute Event Rate: 39.7% vs 46.9%

p-value: p=<0.05

Abstract

Abstract Background and aims COVID-19 has highlighted the link between systemic inflammation and cardiovascular complications, with atrial fibrillation (AF) being associated with poor prognosis and increased cardioembolic stroke risk. Methods The study included 165 patients (62.5 ± 0.9 years; 47% men, 53% women). 116 patients with AF post-COVID-19 were divided into three groups: G1 (n = 36) - new-onset AF after infection; G2 (n = 25) - progression from paroxysmal to persistent or persistent to permanent AF; G3 (n = 55) - AF without changes in form. The control group (CG) - 49 patients with AF without a history of COVID-19. Lymphocyte and monocyte subpopulations in peripheral blood were analyzed using flow cytometry. Results Comparison of NK cell parameters among the groups revealed no statistically significant differences. Patients with post-COVID AF progression (G2) had significantly lower T-helper cell levels compared to those with stable AF (G2 vs G3: 39.7 ± 1.57% vs 46.9 ± 6.0%, p 0.05). CD3+CD8+ cytotoxic T lymphocyte levels were 67.3% higher in G2 compared to G3 (p 0.05). B-lymphocyte levels were lower in G2 than in the control group (8.47 ± 0.60% vs 10.4 ± 0.20%, p 0.005). The proportion of non-classical monocytes (CD14+dimCD16++) was higher in post-COVID AF patients compared to G3 (10.9 ± 0.63% vs 7.5 ± 0.40%, p 0.001). Conclusions Post-COVID AF is associated with immune alterations, including reduced T-helper cells, increased cytotoxic T cells, lower B-lymphocytes, and elevated non-classical monocytes, which may contribute to AF progression and adverse outcomes. Conflict of interest Oksana Stasyshena:nothing to disclose

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Cite This Study

Stasyshena et al. (2026) conducted an observational in Atrial fibrillation post-COVID-19 (n=165). Post-COVID-19 AF progression vs. Stable post-COVID-19 AF was evaluated on T-helper cell levels (p=<0.05). Post-COVID-19 atrial fibrillation progression was associated with significantly lower T-helper cell levels compared to stable post-COVID AF (39.7% vs 46.9%, p<0.05).

synapsesocial.com/papers/69fd7f86bfa21ec5bbf07fd5https://doi.org/10.1093/esj/aakag023.1626
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