Long-term Cardiovascular Outcomes in Patients with Omicron COVID-19 and Elevated Cardiac Biomarkers: A Prospective Multicenter Cohort Study in Shanghai, China.

Background

The long-term cardiovascular outcomes of SARS-CoV-2 omicron-infected patients remain unclear. This study aimed to evaluate acute and long-term cardiovascular risks in hospitalized omicron-infected patients with elevated cardiac biomarkers.

Methods

We included 3012 patients hospitalized in Shanghai, China, between December 1, 2022, and January 31, 2023. Participants were stratified into four groups based on cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Major adverse cardiovascular events (MACEs), all-cause death, cardiovascular death, and cardiovascular-related rehospitalization were evaluated over a 12-month follow-up.

Results

Patients with elevated cTnT and high NT-proBNP had significantly higher risks of MACEs (HRadj=2.85, 95% CI 1.58-5.12), all-cause death (HRadj=5.56, 95% CI 1.51-20.52), cardiovascular death (HRadj=11.97, 95% CI 1.40-102.46), and cardiovascular-related rehospitalization (HRadj=2.38, 95% CI 1.28-4.42). The finding of Subgroup analyses indicated the risk of MACEs were independent of age, gender, hypertension, coronary artery disease, acute coronary syndrome, or heart failure.

Conclusions

Elevated cTnT and NT-proBNP levels during the acute phase of omicron infection predict a substantially increased risk of adverse cardiovascular outcomes within 12 months.