Investigation of hs-TnI and sST-2 as Potential Predictors of Long-Term Cardiovascular Risk in Patients with Survived Hospitalization for COVID-19 Pneumonia
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
Affiliations
Lukas Fiedler
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Lukas J. Motloch
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Peter Jirak
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Ruslan Gumerov
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Paruir Davtyan
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Diana Gareeva
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Irina Lakman
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Alexandr Tataurov
Department of Biomedical Engineering, Ufa University of Science and Technology, Zaki Validi Str. 32, 450076 Ufa, Russia
Gulnaz Lasinova
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Valentin Pavlov
Department of Urology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Laurenz Hauptmann
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Kristen Kopp
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Uta C. Hoppe
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Michael Lichtenauer
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Rudin Pistulli
Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, 48149 Muenster, Germany
Anna-Maria Dieplinger
Nursing Science Program, Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria
Naufal Zagidullin
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
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, p = 0.009), hs-TnI (HR = 4.940, 95% CI = 1.904–12.816, p = 0.001) and sST-2 (HR = 10.901, 95% CI = 4.509–29.271, p < 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.
