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Int J Med Sci . Long-term Cardiovascular Outcomes in Patients with Omicron COVID-19 and Elevated Cardiac Biomarkers: A Prospective Multicenter Cohor

tetano

Editor, Senior Moderator
Int J Med Sci


. 2025 Jun 9;22(12):2884-2895.
doi: 10.7150/ijms.112282. eCollection 2025. Long-term Cardiovascular Outcomes in Patients with Omicron COVID-19 and Elevated Cardiac Biomarkers: A Prospective Multicenter Cohort Study in Shanghai, China

Shun Yao[SUP] 1 [/SUP], Yamei Xu[SUP] 1 [/SUP], Zhonglei Xie[SUP] 1 2 [/SUP], Shuai Yuan[SUP] 1 [/SUP], Junqing Gao[SUP] 3 [/SUP], Qianwei Chen[SUP] 4 [/SUP], Kailei Shi[SUP] 4 [/SUP], Zongjun Liu[SUP] 3 [/SUP], Xiaotong Cui[SUP] 1 [/SUP], Yanyan Wang[SUP] 1 [/SUP], Yu Song[SUP] 1 [/SUP], Xueting Han[SUP] 1 [/SUP], Junbo Ge[SUP] 1 [/SUP], Zhenju Song[SUP] 5 [/SUP], Jingmin Zhou[SUP] 1 [/SUP]



Affiliations
Abstract

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.

Keywords: N-terminal pro-B-type natriuretic peptide (NT-proBNP); Omicron variant; cardiac troponins T (cTnT); coronavirus disease 2019 (COVID-19); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

 
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