Cardiovascular Biomarkers for Prediction of in-hospital and 1-Year Post-discharge Mortality in Patients With COVID-19 Pneumonia

Lukas J Motloch; Peter Jirak; Diana Gareeva; Paruir Davtyan; Ruslan Gumerov; Irina Lakman; Aleksandr Tataurov; Rustem Zulkarneev; Ildar Kabirov; Benzhi Cai; Bairas Valeev; Valentin Pavlov; Kristen Kopp; Uta C Hoppe; Michael Lichtenauer; Lukas Fiedler; Rudin Pistulli; Naufal Zagidullin

doi:10.3389/fmed.2022.906665

Cardiovascular Biomarkers for Prediction of in-hospital and 1-Year Post-discharge Mortality in Patients With COVID-19 Pneumonia

Front Med (Lausanne). 2022 Jun 28:9:906665. doi: 10.3389/fmed.2022.906665. eCollection 2022.

Authors

Lukas J Motloch¹, Peter Jirak¹, Diana Gareeva^{2

3}, Paruir Davtyan^{2

3}, Ruslan Gumerov^{2

3}, Irina Lakman^{2

3

4

5}, Aleksandr Tataurov⁵, Rustem Zulkarneev³, Ildar Kabirov⁶, Benzhi Cai^{2

7}, Bairas Valeev³, Valentin Pavlov^{2

6}, Kristen Kopp¹, Uta C Hoppe¹, Michael Lichtenauer¹, Lukas Fiedler^{1

8}, Rudin Pistulli⁹, Naufal Zagidullin^{2

3

4}

Affiliations

¹ University Clinic for Internal Medicine II, Paracelsus Medical University, Salzburg, Austria.
² Cardiovascular Disease in COVID-19, International Research Network, Ufa, Russia.
³ Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia.
⁴ Department of Biomedical Engineering, Ufa State Aviation Technical University, Ufa, Russia.
⁵ Scientific Laboratory for the Socio-Economic Region Problems Investigation, Bashkir State University, Ufa, Russia.
⁶ Department of Urology, Bashkir State Medical University, Ufa, Russia.
⁷ The Key Laboratory of Cardiovascular Medicine Research, Ministry of Education, Department of Pharmacy at the Second Affiliated Hospital, and Department of Pharmacology at College of Pharmacy, Harbin Medical University, Harbin, China.
⁸ Department of Internal Medicine, Cardiology, Nephrology and Intensive Care Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria.
⁹ Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Munster, Munster, Germany.

Abstract

Aims: While COVID-19 affects the cardiovascular system, the potential clinical impact of cardiovascular biomarkers on predicting outcomes in COVID-19 patients is still unknown. Therefore, to investigate this issue we analyzed the prognostic potential of cardiac biomarkers on in-hospital and long-term post-discharge mortality of patients with COVID-19 pneumonia.

Methods: Serum soluble ST2, VCAM-1, and hs-TnI were evaluated upon admission in 280 consecutive patients hospitalized with COVID-19-associated pneumonia in a single, tertiary care center. Patient clinical and laboratory characteristics and the concentration of biomarkers were correlated with in-hospital [Hospital stay: 11 days (10; 14)] and post-discharge all-cause mortality at 1 year follow-up [FU: 354 days (342; 361)].

Results: 11 patients died while hospitalized for COVID-19 (3.9%), and 11 patients died during the 1-year post-discharge follow-up period (n = 11, 4.1%). Using multivariate analysis, VCAM-1 was shown to predict mortality during the hospital period (HR 1.081, CI 95% 1.035;1.129, p = 0.017), but not ST2 or hs-TnI. In contrast, during one-year FU post hospital discharge, ST2 (HR 1.006, 95% CI 1.002;1.009, p < 0.001) and hs-TnI (HR 1.362, 95% CI 1.050;1.766, p = 0.024) predicted mortality, although not VCAM-1.

Conclusion: In patients hospitalized with Covid-19 pneumonia, elevated levels of VCAM-1 at admission were associated with in-hospital mortality, while ST2 and hs-TnI might predict post-discharge mortality in long term follow-up.

Keywords: COVID-19; VCAM-1; cardiovascular biomarkers; long COVID-19; post-discharge mortality; sST2.