tetano
Editor, Senior Moderator
JCI Insight
. 2025 Dec 22;10(24):e193164.
doi: 10.1172/jci.insight.193164. Innate immune activation and mitochondrial ROS induce acute and persistent cardiac conduction system dysfunction after COVID-19
Deepthi Ashok[SUP] 1 [/SUP], Ting Liu[SUP] 1 [/SUP], Misato Nakanishi-Koakutsu[SUP] 2 3 [/SUP], Joseph Criscione[SUP] 4 [/SUP], Meghana Prakash[SUP] 1 [/SUP], Alexis Tensfeldt[SUP] 1 4 [/SUP], Byunggik Kim[SUP] 5 [/SUP], Bryan Ho[SUP] 4 [/SUP], Julian Chow[SUP] 6 [/SUP], Morgan Craney[SUP] 7 [/SUP], Mark J Ranek[SUP] 1 [/SUP], Brian L Lin[SUP] 1 [/SUP], Kyriakos Papanicolaou[SUP] 1 [/SUP], Agnieszka Sidor[SUP] 1 [/SUP], D Brian Foster[SUP] 1 [/SUP], Hee Cheol Cho[SUP] 2 3 [/SUP], Andrew Pekosz[SUP] 8 [/SUP], Jason Villano[SUP] 7 9 [/SUP], Deok-Ho Kim[SUP] 1 4 10 [/SUP], Brian O'Rourke[SUP] 1 4 10 [/SUP]
Affiliations
Cardiac arrhythmias increase during acute SARS-CoV-2 infection and in long COVID syndrome, by unknown mechanisms. This study explored the acute and long-term effects of COVID-19 on cardiac electrophysiology and the cardiac conduction system (CCS) in a hamster model. Electrocardiograms and subpleural pressures were recorded by telemetry for 4 weeks after SARS-CoV-2 infection, and interferon-stimulated gene expression and macrophage infiltration of the CCS were assessed at 4 days and 4 weeks postinfection. COVID-19 induced pronounced tachypnea and cardiac arrhythmias, including bradycardia and persistent atrioventricular block, though no viral protein expression was detected in the heart. Arrhythmias developed rapidly, partially reversed, and then redeveloped, indicating persistent CCS injury. COVID-19 induced cardiac cytokine expression, connexin mislocalization, and CCS macrophage remodeling. Interestingly, sterile innate immune activation by direct cardiac injection of polyinosinic
olycytidylic acid (PIC) induced arrhythmias similar to those of COVID-19. PIC strongly induced cytokine secretion and interferon signaling in hearts, human induced pluripotent stem cell-derived cardiomyocytes, and engineered heart tissues, accompanied by alterations in excitation-contraction coupling. Importantly, the pulmonary and cardiac effects of COVID-19 were blunted by JAK/STAT inhibition or a mitochondrially targeted antioxidant, indicating that SARS-CoV-2 infection indirectly leads to arrhythmias by innate immune activation and redox stress, which could have implications for long COVID syndrome.
Keywords: Arrhythmias; Cardiology; Immunology; Infectious disease; Innate immunity; Mitochondria.
. 2025 Dec 22;10(24):e193164.
doi: 10.1172/jci.insight.193164. Innate immune activation and mitochondrial ROS induce acute and persistent cardiac conduction system dysfunction after COVID-19
Deepthi Ashok[SUP] 1 [/SUP], Ting Liu[SUP] 1 [/SUP], Misato Nakanishi-Koakutsu[SUP] 2 3 [/SUP], Joseph Criscione[SUP] 4 [/SUP], Meghana Prakash[SUP] 1 [/SUP], Alexis Tensfeldt[SUP] 1 4 [/SUP], Byunggik Kim[SUP] 5 [/SUP], Bryan Ho[SUP] 4 [/SUP], Julian Chow[SUP] 6 [/SUP], Morgan Craney[SUP] 7 [/SUP], Mark J Ranek[SUP] 1 [/SUP], Brian L Lin[SUP] 1 [/SUP], Kyriakos Papanicolaou[SUP] 1 [/SUP], Agnieszka Sidor[SUP] 1 [/SUP], D Brian Foster[SUP] 1 [/SUP], Hee Cheol Cho[SUP] 2 3 [/SUP], Andrew Pekosz[SUP] 8 [/SUP], Jason Villano[SUP] 7 9 [/SUP], Deok-Ho Kim[SUP] 1 4 10 [/SUP], Brian O'Rourke[SUP] 1 4 10 [/SUP]
Affiliations
- PMID: 41424383
- DOI: 10.1172/jci.insight.193164
Cardiac arrhythmias increase during acute SARS-CoV-2 infection and in long COVID syndrome, by unknown mechanisms. This study explored the acute and long-term effects of COVID-19 on cardiac electrophysiology and the cardiac conduction system (CCS) in a hamster model. Electrocardiograms and subpleural pressures were recorded by telemetry for 4 weeks after SARS-CoV-2 infection, and interferon-stimulated gene expression and macrophage infiltration of the CCS were assessed at 4 days and 4 weeks postinfection. COVID-19 induced pronounced tachypnea and cardiac arrhythmias, including bradycardia and persistent atrioventricular block, though no viral protein expression was detected in the heart. Arrhythmias developed rapidly, partially reversed, and then redeveloped, indicating persistent CCS injury. COVID-19 induced cardiac cytokine expression, connexin mislocalization, and CCS macrophage remodeling. Interestingly, sterile innate immune activation by direct cardiac injection of polyinosinic
olycytidylic acid (PIC) induced arrhythmias similar to those of COVID-19. PIC strongly induced cytokine secretion and interferon signaling in hearts, human induced pluripotent stem cell-derived cardiomyocytes, and engineered heart tissues, accompanied by alterations in excitation-contraction coupling. Importantly, the pulmonary and cardiac effects of COVID-19 were blunted by JAK/STAT inhibition or a mitochondrially targeted antioxidant, indicating that SARS-CoV-2 infection indirectly leads to arrhythmias by innate immune activation and redox stress, which could have implications for long COVID syndrome.Keywords: Arrhythmias; Cardiology; Immunology; Infectious disease; Innate immunity; Mitochondria.