OBJECTIVES: The overexpression of plasminogen activator inhibitor-1 (PAI-1) was frequently observed during coronavirus disease 2019 (COVID-19), and it was found to be closely associated with disease severity. We have analyzed the PAI-1 status in fully recovered post-COVID patients. SUBJECTS AND METHODS: In a case-control and cross-sectional study, we compared 377 patients, 30-210 days after PCR-verified COVID-19 and 884 COVID-naive controls. RESULTS: Post-COVID patients ("cases") showed significantly higher plasma PAI-1 concentrations than COVID-naive controls. This difference remained significant even after complex adjustment by multiple regression. On the other hand, since the strongest covariate of increased PAI-1 was antihypertensive treatment, the difference between cases and controls in those who were on antihypertensives completely disappeared. In the subgroup of post-COVID patients only, we also found that highly symptomatic patients or those who required hospitalization in the acute phase showed significantly higher PAI-1 than patients with only mild symptoms of the disease. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1. Similarly, the presence of β mutation increased the relative risk (≈11 times) of high post-COVID concentrations of PAI-1. CONCLUSIONS: Increased values of PAI-1 can persist for several months after complete recovery from COVID-19 (namely, by β variant of the virus), and their expression also corresponded to clinical course of the disease.

2nd Department of Internal Medicine Medical Faculty of Charles University and University Hospital Pilsen Czechia

Biomedical Center Medical Faculty of Charles University Pilsen Czechia

Department of Epidemiology University Hospital Pilsen Czechia

Department of Immunodiagnostics University Hospital Pilsen Czechia

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