Elevated markers of thrombo-inflammatory activation predict outcome in patients with cardiovascular comorbidities and COVID-19 disease: insights from the LEOSS registry

  • Aims: SARS-CoV-2 infection is associated with adverse outcomes in patients with cardiovascular disease. Here, we analyzed whether specific biomarkers predict the clinical course of COVID-19 in patients with cardiovascular comorbidities. Methods and results: We enrolled 2147 patients with SARS-CoV-2 infection which were included in the Lean European Open Survey on SARS-CoV‑2 (LEOSS)-registry from March to June 2020. Clinical data and laboratory values were collected and compared between patients with and without cardiovascular comorbidities in different clinical stages of the disease. Predictors for mortality were calculated using multivariate regression analysis. We show that patients with cardiovascular comorbidities display significantly higher markers of myocardial injury and thrombo-inflammatory activation already in the uncomplicated phase of COVID-19. In multivariate analysis, elevated levels of troponin [OR 1.54; (95% CI 1.22–1.96), p < 0.001)], IL-6 [OR 1.69 (95% CI 1.26–2.27), p < 0.013)], and CRP [OR 1.32; (95% CI 1.1–1.58), p < 0.003)] were predictors of mortality in patients with COVID-19. Conclusion: Patients with cardiovascular comorbidities show elevated markers of thrombo-inflammatory activation and myocardial injury, which predict mortality, already in the uncomplicated phase of COVID-19. Starting targeted anti-inflammatory therapy and aggressive anticoagulation already in the uncomplicated phase of the disease might improve outcomes after SARS-CoV-2 infection in patients with cardiovascular comorbidities.
Author:Sebastian CremerGND, Carolin Ellen Marianne JakobORCiDGND, Alexander BerkowitschGND, Stefan BorgmannGND, Lisa PilgramORCiDGND, Lukas TomettenORCiDGND, Annika ClaßenORCiDGND, Kai WilleORCiDGND, Simon WeidlichORCiD, Beate GrünerORCiDGND, Stefanie DimmelerORCiDGND, Steffen MaßbergORCiDGND, Siegbert RiegORCiDGND, Andreas M. ZeiherORCiDGND
Parent Title (English):Clinical research in cardiology
Place of publication:Berlin
Document Type:Article
Date of Publication (online):2020/11/19
Date of first Publication:2020/11/19
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Contributing Corporation:LEOSS study group
Release Date:2022/06/28
Tag:COVID-19; Coagulation; Inflammation; Mortality; Myocardial injury
Page Number:12
First Page:1029
Last Page:1040
Open Access funding enabled and organized by Projekt DEAL. The study was supported by the German Center for Infection Research, the Pitzer Foundation to J.V., and the German Center for Cardiovascular Research DZHK, Berlin, Germany to A.B.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0