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. 2022 Jun 28:9:906665.
doi: 10.3389/fmed.2022.906665. eCollection 2022.

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

Lukas J Motloch  1 , Peter Jirak  1 , Diana Gareeva  2   3 , Paruir Davtyan  2   3 , Ruslan Gumerov  2   3 , Irina Lakman  2   3   4   5 , Aleksandr Tataurov  5 , Rustem Zulkarneev  3 , Ildar Kabirov  6 , Benzhi Cai  2   7 , Bairas Valeev  3 , Valentin Pavlov  2   6 , Kristen Kopp  1 , Uta C Hoppe  1 , Michael Lichtenauer  1 , Lukas Fiedler  1   8 , Rudin Pistulli  9 , Naufal Zagidullin  2   3   4
Affiliations

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

Lukas J Motloch et al. Front Med (Lausanne). .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Design of the study.
Figure 2
Figure 2
Mathematical model of the statistical analyses. ST2, soluble suppression of tumorigenicity 2; VCAM-1, vascular cells adhesion molecule-1; TnI, high sensitive troponin I.
Figure 3
Figure 3
Independent predictors of hospital mortality from COVID-19 in multivariable survival regression (Bayesian Hierarchical Cox model) in a multi-marker model. Results are reported as hazard ratio (HR) and 95% confidence intervals (CIs).
Figure 4
Figure 4
Independent predictors of post-hospital 1-year FU mortality in patients hospitalized with COVID-19, in a multivariate survival analysis using Cox's regression model. Results are reported as hazard ratios (HR) and 95% confidence intervals (CIs).
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