Cardiac biomarkers on admission and in‑hospital mortality in COVID-19 patients with or without concomitant heart failure.

High‑sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT‑ proBNP) are known markers of cardiac injury. However, their role in predicting the severity of COVID‑19 remains to be investigated. We aimed to analyze the association between hs‑cTnT and NT-proBNP levels and in hospital mortality in patients with COVID‑19, with emphasis on those with concomitant chronic heart failure (CHF). A total of 1729 consecutive patients with COVID‑19 were enrolled. Demographic data, laboratory parameters, and clinical outcomes (discharge or death) were analyzed. Receiver operating characteristic (ROC) and logistic regression analyses were performed to evaluate the association between hs‑cTnT and NT-proBNP values and the risk of death. Evaluation of hs‑cTnT was performed in 1041 patients, while NT-proBNP was assessed in 715 individuals. CHF was present in 179 cases (10.4% of the cohort). Median values of hs‑cTnT and NT-proBNP and in‑hospital mortality were higher in CHF patients than in those without CHF. Among patients without CHF, mortality was the highest in those with hs‑cTnT or NT-proBNP values in the fourth quartile. In ROC analysis, hs‑cTnT equal to or above 142 ng/l and NT-proBNP equal to or above 969 pg/ml predicted in‑hospital death. In patients without CHF, each 10-ng/l increase in hs-cTnT or 100-pg/ml increase in NT‑proBNP was associated with a higher risk of death (odds ratio [OR], 1.01 and OR, 1.02, respectively; P <0.01 for both). The level of hs‑cTnT or NT-proBNP predicts in hospital mortality in COVID-19 patients. Both hs‑cTnT and NT-proBNP should be routinely measured on admission in all patients hospitalized due to COVID‑19 for early detection of individuals with an increased risk of in hospital death, even if they do not have concomitant heart failure.