Post-COVID Complications after Pressure Ulcer Surgery in Patients with Spinal Cord Injury Associate with Creatine Kinase Upregulation in Adipose Tissue

Cells, 2022 · DOI: https://doi.org/10.3390/cells11081282 · Published: April 9, 2022

Simple Explanation

This study investigates complications following pressure ulcer surgery in spinal cord injury (SCI) patients, comparing those with and without prior COVID-19 infection. The research analyzes adipose tissue surrounding ulcers to identify molecular indicators of impaired recovery in post-COVID-19 patients. The key finding suggests that elevated creatine kinase levels and the presence of multinucleated giant cells in adipose tissue may predict postsurgical complications in these patients.

Study Duration

January 2019 to July 2021

Participants

23 SCI patients with pressure ulcers (17 included after exclusions)

Evidence Level

Not specified

Key Findings

1
SCI patients with a recent COVID-19 diagnosis experienced worse recovery and severe postoperative complications after pressure ulcer surgery, often requiring reintervention.
2
Creatine kinase isoforms (CKMT2 and CKM) were significantly upregulated in the adipose tissue of post-COVID-19 patients.
3
Multinucleated giant cells (MGCs) expressing CKM and CKMT2 were found in the adipose tissue of COVID-19 patients, suggesting an inflammatory response.

Research Summary

The study evaluated surgical outcomes in SCI patients undergoing pressure ulcer reconstruction, comparing pre-pandemic (non-COVID) and pandemic (post-COVID) groups. Post-COVID patients showed increased postoperative complications, prolonged recovery, and elevated creatine kinase levels in adipose tissue. The presence of multinucleated giant cells and autoantibodies against adipose tissue proteins were also observed in post-COVID patients, indicating a potential immune response affecting recovery.

Practical Implications

Prognostic Biomarkers

CKMT2, CKM, and MGCs in adipose tissue may serve as predictive biomarkers for postsurgical complications in post-COVID SCI patients.

Surgical Timing

Delaying surgery in post-COVID patients until CKM/CKMT2 levels decrease may improve recovery outcomes.

Therapeutic Strategies

Targeting the inflammatory response in adipose tissue could be a potential strategy to improve postsurgical healing in post-COVID patients.

Study Limitations

1
Limited sample size.
2
The underlying mechanisms of autoantibody production and their role in impaired wound healing remain unclear.
3
Further research is needed to validate these findings and explore potential therapeutic interventions.

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