The involvement of circulating miR‐146a and miR‐27a in patients with atherosclerotic cardiovascular disease after SARS‐CoV‐2 infection

Background Atherosclerotic cardiovascular disease (ASCVD) is a group of clinical diseases based on pathology of atherosclerosis that is the leading cause of mortality worldwide. There is a bidirectional interaction between ASCVD and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Alterations in circulating miRNAs levels are involved in the development of ASCVD in patients infected with SARS‐CoV‐2, however, the correlation between ASCVD co‐infection with SARS‐CoV‐2 and alterations of cardiac‐specific miRNAs is not well understood. Hypothesis The circulating miR‐146a and miR‐27a are involved in bidirectional interactions between ASCVD and SARS‐CoV‐2 infections. Methods Circulating miR‐146a and miR‐27a levels were measured in serum and PBMCs deriving from ASCVD patients and controls after SARS‐CoV‐2 infection by qRT‐PCR analysis. The levels of neutralizing antibodies‐resistant SARS‐CoV‐2 in human serum was determined by competitive magnetic particle chemiluminescence method. Interleukin (IL)‐6 levels were detected by automatic biochemical analyzer using electrochemiluminescence. Results Significant downregulation of circulating miR‐146a and upregulation of miR‐27a in ASCVD patients after infection with SARS‐CoV‐2 compared with controls were observed, among which the alterations were more evident in ASCVD patients comorbid with hyperlipidemia and diabetes mellitus. Consistently, correlation analysis revealed that serum miR‐146a and miR‐27a levels were associated with the levels of lipids and glucose, inflammatory response, and immune function in ASCVD patients. Remarkably, SARS‐CoV‐2 S protein RBD stimulation of PBMCs derived from both ASCVD and controls significantly downregulated miR‐146a, upregulated miR‐27a expression levels, and promoted IL‐6 release in vitro. Conclusions The circulating miR‐146a and miR‐27a are involved in metabolism, inflammation, and immune levels in patients with ASCVD after SARS‐CoV‐2 infection, laying the foundation for the development of strategies to prevent the risk of SARS‐CoV‐2 infection in ASCVD patients. Patients with atherosclerotic cardiovascular disease are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and suffer more severe conditions and outcomes, miR‐146a and miR‐27a are involved in bidirectional interactions between ASCVD and SARS‐CoV‐2 infections, and are associated with metabolism, inflammation, and immune levels.