SUN-254 Clinical utility of plasma brain natriuretic peptide for evaluation of prolonged symptoms of long COVID

Abstract Disclosure: Y. Masuda: None. Y. Otsuka: None. K. Tokumasu: None. H. Honda: None. Y. Sakurada: None. Y. Matsuda: None. Y. Nakano: None. R. Takase: None. D. Omura: None. T. Hasegawa: None. K. Ueda: None. F. Otsuka: None. Long COVID leads to a decline in the quality of life of patients and often results in difficulty in working. Several clinical indicators for inflammatory and endocrine dysfunctions in patients with long COVID have been established. However, a specific biomarker for assessing treatment response and estimating prognosis of long COVID has not been established. SARS-CoV-2 infection induces systemic effects including cardiovascular involvement and related complications. Since cardiac myocytes secrete brain natriuretic peptide (BNP) in response to cardiac wall stress, BNP is clinically useful for diagnosing and estimating the prognosis of heart failure. Recently, it has been suggested that cardiac injuries induced by SARS-CoV-2 are involved in the “fatigue” related to COVID-19 and/or long COVID. In the acute phase of COVID-19, it has been shown that BNP level is a possible predictor for prognosis and that BNP level is elevated in patients with severe COVID-19, whereas another study showed that the viral infection itself has no direct impact on cardiac markers such as BNP and troponin. Thus far, evidence for the usefulness of biomarkers that aid in diagnosis, assessment of severity, and prediction of prognosis in patients with long COVID is limited. The present aim of this study was to clarify the characteristics of BNP in long COVID. We conducted a retrospective observational study of patients who visited the COVID-19 aftercare outpatient clinic at Okayama University Hospital from February 2021 to April 2024. A total of 428 patients were enrolled in this study and the patients were divided into a group with normal BNP (n=314, ≦18.4 pg/mL) and a group with increased BNP (n=114, >18.4 pg/mL). As a result, the long COVID group with increased BNP had a higher proportion of females (44.3% vs. 73.7%, P<0.01) and an older median age (38 vs. 51 years, P<0.01). Fatigue and brain fog were commonly manifested in both groups, while dyspnea was a more frequent complaint in the group with increased BNP. Various symptoms including fatigue, palpitations, and taste and/or olfactory disorders were associated with elevated BNP (23 to 24 pg/mL). Memory impairment was also linked to higher BNP (OR: 2.36, P=0.05). In long COVID patients, plasma BNP elevation appears to be more pronounced in females and is often related to cardiogenic factors, in which inflammation may also be involved. In conclusion, plasma BNP measurement can be useful for evaluating the severity of various symptoms related to long COVID, especially in female patients and those with respiratory symptoms and/or memory impairment. Presentation: Sunday, July 13, 2025