Abstract
Background COVID-19 may present with a variety of cardiovascular manifestations, and elevations of biomarkers reflecting myocardial injury and stress are prevalent. SARS-CoV-2 has been found in cardiac tissue, and myocardial dysfunction post-COVID-19 may occur. However, the association between SARS-CoV-2 RNA in plasma and cardiovascular biomarkers remains unknown. Methods and Results COVID MECH (COVID-19 Mechanisms) was a prospective, observational study enrolling consecutive, hospitalized patients with laboratory-confirmed infection with SARS-CoV-2 and symptoms of COVID-19. Biobank plasma samples used to measure SARS-CoV-2 RNA and cardiovascular and inflammatory biomarkers were collected in 123 patients at baseline, and in 96 patients (78%) at day 3. Patients were aged 60±15 (mean ± SD) years, 71 (58%) were men, 68 (55%) were White, and 31 (25%) received mechanical ventilation during hospitalization. SARS-CoV-2 RNA was detected in plasma from 48 (39%) patients at baseline. Patients with viremia were more frequently men, had more diabetes mellitus, and lower oxygen saturation. Patients with viremia had higher concentrations of interleukin-6, C-reactive protein, procalcitonin, and ferritin (all <0.001), but comparable levels of cTnT (cardiac troponin T; P =0.09), NT-proBNP (N-terminal pro-B-type natriuretic peptide; P =0.27) and D-dimer ( P =0.67) to patients without viremia. SARS-CoV-2 RNA was present in plasma at either baseline or day 3 in 50 (52%) patients, and these patients experienced increase from baseline to day 3 in NT-proBNP and D-dimer concentrations, while there was no change in cTnT. Conclusions SARS-CoV-2 viremia was associated with increased concentrations of inflammatory, but not cardiovascular biomarkers. NT-proBNP and D-dimer, but not cTnT, increased from baseline to day 3 in patients with viremia. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04314232 .
Keywords: COVID‐19; RNA; SARS‐CoV‐2; biomarkers; cardiovascular; viremia.
【저자키워드】 Biomarkers, COVID‐19, RNA, SARS‐CoV‐2, cardiovascular, viremia., 【초록키워드】 COVID-19, SARS-CoV-2, Biomarker, Biomarkers, Stress, mechanical ventilation, Hospitalization, Diabetes Mellitus, interleukin-6, peptide, C-reactive protein, D-dimer, ferritin, procalcitonin, oxygen, diabetes, hospitalized patients, observational study, cardiovascular, cardiac troponin, COVID, Registration, myocardial injury, Biobank, interleukin, Viremia, Patient, Manifestations, troponin T, plasma, SARS-CoV-2 RNA, NT-proBNP, patients, association, Inflammatory biomarker, Concentration, Inflammatory, Myocardial dysfunction, cardiac troponin T, tissue, dimer, Elevation, white, symptoms of COVID-19, N-terminal pro-B-type natriuretic peptide, elevations, cTnT, lower oxygen saturation, laboratory-confirmed, N-terminal, men, concentrations, prevalent, plasma sample, Result, collected, occur, variety, hospitalized patient, comparable, baseline, had more, infection with SARS-CoV-2, 【제목키워드】 COVID-19, SARS-CoV-2,