J-WAVES AND CARDIAC BIOMARKERS ARE ASSOCIATED WITH LONG-TERM CARDIOVASCULAR OUTCOMES IN HOSPITALIZED COVID-19 PATIENTS

Highlights

• We propose serum biomarkers as risk assessment tools for patients with COVID-19.
• J-waves are a common ECG finding, detected in 4–6% of the population, and are a risk factor for ventricular tachycardia and mortality in COVID-19 patients.

Aim. To evaluate the prognostic potential of a combination of cardiac-specific biomarkers and ECG J-waves regarding long-term mortality and cardiovascular complications after discharge in patients with COVID-19-associated pneumonia.

Methods. Serum biomarkers sST2, VCAM-1 and hs-TnI were assessed at admission in 254 patients hospitalized with COVID-19-associated pneumonia. ECGs on admission were analyzed for the presence of J waves. Clinical and laboratory characteristics of patients, as well as biomarker concentrations and the presence of J-waves on the ECG, were correlated with mortality and cardiovascular complications after discharge at 12 months [FU: 347 (310, 449) days]. Cox proportional hazards models were used to identify predictors of the risk of mortality and the composite endpoint up to one year after discharge.

Results. A high level of VCAM-1 was a significant predictor of the risk of a combined endpoint (MI, stroke, pulmonary embolism, sudden death): HR = 1.049, CI 95%: 1.016–1.083; and high sST2 level was a significant predictor of the risk of both death (HR = 1.006, CI 95%: 1.004–1.007) and the composite endpoint (HR = 1.005, CI 95%: 1.003–1.006). In the generalized multivariate model, when other influencing factors were combined, the presence of a J-wave on the ECG during hospitalization was statistically insignificant (p > 0.5) for predicting sudden death up to a year after discharge.

Conclusion. In hospitalized COVID-19 survivors, elevated hsTnI and sST2 levels on admission were strong predictors of CV events during long-term follow-up. On the other hand, the significance of the J-wave on the ECG in predicting long-term CV events remains borderline.

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