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

ORCID
0000-0003-2626-3098
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Fiedler, Lukas;
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Motloch, Lukas J.;
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Jirak, Peter;
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Gumerov, Ruslan;
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Davtyan, Paruir;
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Gareeva, Diana;
ORCID
0000-0001-9876-9202
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Lakman, Irina;
Affiliation
Department of Biomedical Engineering, Ufa University of Science and Technology, Zaki Validi Str. 32, 450076 Ufa, Russia
Tataurov, Alexandr;
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Lasinova, Gulnaz;
Affiliation
Department of Urology, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Pavlov, Valentin;
ORCID
0000-0003-2674-3796
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Hauptmann, Laurenz;
ORCID
0000-0002-7265-8560
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Kopp, Kristen;
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Hoppe, Uta C.;
Affiliation
University Clinic for Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
Lichtenauer, Michael;
ORCID
0000-0001-7676-3942
Affiliation
Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, 48149 Muenster, Germany
Pistulli, Rudin;
Affiliation
Nursing Science Program, Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria
Dieplinger, Anna-Maria;
ORCID
0000-0003-2386-6707
Affiliation
Department of Internal Diseases, Bashkir State Medical University, Lenin Str. 3, 450008 Ufa, Russia
Zagidullin, Naufal

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.

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