Investigation of hs-TnI and sST-2 as Potential Predictors of Long-Term Cardiovascular Risk in Patients with Survived Hospitalization for COVID-19 Pneumonia

oleh: Lukas Fiedler, Lukas J. Motloch, Peter Jirak, Ruslan Gumerov, Paruir Davtyan, Diana Gareeva, Irina Lakman, Alexandr Tataurov, Gulnaz Lasinova, Valentin Pavlov, Laurenz Hauptmann, Kristen Kopp, Uta C. Hoppe, Michael Lichtenauer, Rudin Pistulli, Anna-Maria Dieplinger, Naufal Zagidullin

Format: Article
Diterbitkan: MDPI AG 2022-11-01

Deskripsi

Introduction: COVID-19 survivors reveal an increased long-term risk for cardiovascular disease. Biomarkers like troponins and sST-2 improve stratification of cardiovascular risk. Nevertheless, their prognostic value for identifying long-term cardiovascular risk after having survived COVID-19 has yet to be evaluated. Methods: In this single-center study, admission serum biomarkers of sST-2 and hs-TnI in a single cohort of 251 hospitalized COVID-19 survivors were evaluated. Concentrations were correlated with major cardiovascular events (MACE) defined as cardiovascular death and/or need for cardiovascular hospitalization during follow-up after hospital discharge [FU: 415 days (403; 422)]. Results: MACE was a frequent finding during FU with an incidence of 8.4% (cardiovascular death: 2.8% and/or need for cardiovascular hospitalization: 7.2%). Both biomarkers were reliable indicators of MACE (hs-TnI: sensitivity = 66.7% & specificity = 65.7%; sST-2: sensitivity = 33.3% & specificity = 97.4%). This was confirmed in a multivariate proportional-hazards analysis: besides age (HR = 1.047, 95% CI = 1.012–1.084, <i>p</i> = 0.009), hs-TnI (HR = 4.940, 95% CI = 1.904–12.816, <i>p</i> = 0.001) and sST-2 (HR = 10.901, 95% CI = 4.509–29.271, <i>p</i> < 0.001) were strong predictors of MACE. The predictive value of the model was further improved by combining both biomarkers with the factor age (concordance index hs-TnI + sST2 + age = 0.812). Conclusion: During long-term FU, hospitalized COVID-19 survivors, hs-TnI and sST-2 at admission, were strong predictors of MACE, indicating both proteins to be involved in post-acute sequelae of COVID-19.