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.