Linking COVID-19 and Cardiovascular Risk: The Diagnostic Potential of Asymmetric Dimethylarginine, Neopterin, and Vitamin D in Coronary Artery Disease

新冠病毒感染与心血管风险的关联:不对称二甲基精氨酸、新蝶呤和维生素D在冠状动脉疾病诊断中的应用潜力

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Abstract

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with more severe clinical outcomes and increased mortality, particularly in individuals with comorbidities, such as hypertension and diabetes. This study aimed to evaluate the risk of developing coronary artery disease (CAD) about COVID-19 infection and vaccination status by measuring the serum levels of asymmetric dimethylarginine (ADMA), neopterin (NP), and vitamin D. MATERIALS AND METHODS: A total of 120 volunteers aged 30-65 years, presenting to a Chest Diseases Outpatient Clinic, were enrolled and categorized into four groups: COVID-19(+) vaccinated; COVID-19(+) unvaccinated; COVID-19(-) vaccinated; and COVID-19(-) unvaccinated. Routine biochemical parameters were assessed using an autoanalyzer. Serum ADMA and NP levels were quantified via enzyme-linked immunosorbent assay (ELISA), while vitamin D levels were obtained using a chromatography-based method. RESULTS: According to the findings of our study, the serum levels of both ADMA and NP were elevated in individuals with COVID-19. While the increase in ADMA was statistically significant (p<0.05), the increase in NP was not (p>0.05). Furthermore, the lower, though not significant, vitamin D observed in COVID-19-positive participants is considered a significant finding. However, higher vitamin D was observed in vaccinated individuals compared to unvaccinated individuals, which was not statistically significant (p>0.05). DISCUSSION AND CONCLUSION: The side effects of COVID-19 infection and vaccination continue to be a significant concern for all societies. Our study examined the association with the increased risk of CAD associated with this process. Our findings suggest that COVID-19 infection potentially influences CAD risk by affecting inflammatory and endothelial biomarkers, such as ADMA and NP. Simultaneous assessment of these markers can provide valuable information for cardiovascular risk profiling. Vaccination appears protective; it helps maintain higher vitamin D levels and is associated with a more controlled immune response, rather than increased risk. Including vitamin D status in this assessment may further clarify the interaction between immune function and vascular health.

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