Journal Article

Comorbidities, sequelae, blood biomarkers and their associated clinical outcomes in the Mount Sinai Health System COVID-19 patients

Bander, Jeffrey, Goukassian, David A., Fish, Kenneth M., Bisserier, Malik, Garikipati, Venkata Naga Srikanth, Hadri, Lahouaria, Brojakowska, Agnieszka, Eskandari, Abrisham

2021

Overview

With the continuing rise of SARS-CoV2 infection globally and the emergence of various waves in different countries, understanding characteristics of susceptibility to infection, clinical severity, and outcomes remain vital. In this retrospective study, data was extracted for 39,539 patients from the de-identified Mount Sinai Health System COVID-19 database. We assessed the risk of mortality based on the presence of comorbidities and organ-specific sequelae in 7,032 CoV2 positive (+) patients. Prevalence of cardiovascular and metabolic comorbidities was high among SARS-CoV2+ individuals. Diabetes, obesity, coronary artery disease, hypertension, atrial fibrillation, and heart failure all increased overall mortality risk, while asthma did not. Ethnicity modified the risk of mortality associated with these comorbidities. With regards to secondary complications in the setting of infection, individuals with acute kidney injury and acute myocardial injury showed an increase in mortality risk. Cerebral infarcts and acute venous thromboembolic events were not associated with increased risk of mortality. Biomarkers for cardiovascular injury, coagulation, and inflammation were compared between deceased and survived individuals. We found that cardiac and coagulation biomarkers were elevated and fell beyond normal range more often in deceased patients. Several, but not all, inflammatory markers evaluated were increased in deceased patients. In summary, we identified comorbidities and sequelae along with peripheral blood biomarkers that were associated with elevated clinical severity and poor outcomes in COVID-19 patients. Overall, these findings detail the granularity of previously reported factors which may impact susceptibility, clinical severity, and mortality during the course of COVID-19 disease.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Analysis / Asthma / Biological markers / Biology and Life Sciences / Biomarkers / Biomarkers - blood / Blood / Cardiovascular diseases / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - ethnology / Clinical outcomes / Coagulation / Comorbidity / Complications / Congestive heart failure / Coronary artery / Coronary artery disease / Coronaviruses / COVID-19 / COVID-19 - mortality / COVID-19 - pathology / COVID-19 - virology / Databases, Factual / Diabetes mellitus / Diabetes Mellitus - epidemiology / Diabetes Mellitus - ethnology / Disease / Electronic health records / Emergency medical care / Ethnicity / Evaluation / Fibrillation / Health risks / Heart diseases / Humans / Hypertension / Infections / Inflammation / Injuries / Medical records / Medicine / Medicine and Health Sciences / Minority & ethnic groups / Mortality / Mortality risk / Pandemics / Patients / Peripheral blood / Prevalence / Real-Time Polymerase Chain Reaction / Retrospective Studies / Risk assessment / Risk Factors / RNA, Viral - analysis / SARS-CoV-2 - genetics / SARS-CoV-2 - isolation & purification / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Survival Analysis / Thromboembolism / Viral diseases