Abstract 18365: Elevated Biomarkers of Subclinical Myocardial Injury and Inflammation Among Community-Dwelling Adults With Covid-19

Abstract

Background: Subclinical cardiovascular impact of SARS-CoV-2 infection in mild-moderate cases is unclear. Hypothesis We hypothesized that positive anti-nucleocapsid/spike SARS-CoV-2 antibodies will be associated with elevated subclinical cardiac and inflammatory biomarkers. Methods: This study was nested within a randomized controlled trial among community-dwelling adults. We used logistic regression to estimate adjusted odds of positive anti-nucleocapsid/ spike protein antibodies and elevated cardiac and inflammatory biomarkers (high-sensitivity cardiac troponin [hs-TnI], N-terminal pro-B-type natriuretic peptide [NT-proBNP], Galectin-3 [Gal-3], and C-reactive protein, [CRP]). Results: Among 231 adults, mean (±SD) age was 50 (±17.6) years, 63% were female, 57% were Black persons. Overall, 11% had detectable hs-cTnI (≥6 ng/L), 21% had elevated NT-proBNP (≥125pg/dL), 42% had elevated Gal-3 (≥18.5 ng/mL), 70% had elevated CRP (≥0.9 mg/dL). CRP levels were significantly higher among persons with positive spike protein antibodies [positive: median, 1.9 (Interquartile range IQR, 4.1) vs. negative: median, 0.7 (IQR, 2.1); p=0.014]. Those with positive spike protein antibodies were 3.49 (95% CI, 1.33-9.15) times more likely to have elevated CRP than those who were negative. Cardiac/inflammatory biomarkers were slightly higher in persons with positive SARS-CoV-2 IgG antibody detecting nucleocapsid protein (virus-specific antibody) versus negative ( Figure ). Conclusions: In this sample, we observed elevated cardiac and inflammatory biomarkers indicative of myocardial injury. Further research on the durability of elevated cardiac biomarkers and their contributions to post-acute sequela of COVID-19 is needed.