The COVID-19 pandemic has highlighted the importance of cardiometabolic testing

Patients with preexisting CVD are at increased risk for severe COVID-19 infection and death.^4-6 The mortality rate for patients with underlying conditions such as CVD or diabetes is 19.5% compared to a 1.6% mortality rate for patients with no reported underlying conditions.⁶ The reasons are unclear but may be related to generally poorer health status, changes in ACE2 receptors as a result of medical treatment, or underlying immune dysfunction as a result of the CVD.^4,8,9

Patients with preexisting CVD are also at risk for developing a critical illness.^4,8,9 Additionally, patients with co-morbidities such as diabetes, chronic kidney disease, and chronic obstructive pulmonary disease (COPD) are at increased risk of cardiac involvement during a COVID-19 infection.^4,8,9

Identifying patients most at risk for severe outcomes

Heart disease remains the leading cause of death in the US. Also the severity of upper respiratory infections such as COVID-19 or seasonal flu can significantly compound complications to patients most at risk.

The American College of Cardiology notes a COVID-19 case fatality ratio 3 times higher for diabetes and 4 times higher for cardiovascular disease.⁵

The CDC agrees that patients who are obese or have heart conditions are at a greater risk for severe diseases such as COVID-19.¹⁰

The risk for onset of cardiovascular disease increases after COVID-19 infection

According to a recent study in NEJM, complications from COVID-19 can lead to increased risk for myocardial infarction (MI) within 7 days of a viral infection compared to before the infection (≤65yo: 2.4x increased risk, >65yo: 7.3x increased risk).⁷ The increase in MI rate is thought to be driven by the increase in vascular inflammation and risk of plaque rupture due to respiratory viral infection.

The American College of Cardiology suggests that up to 17% of hospitalized patients could develop arrhythmia and 7% could experience acute cardiac injury.⁵

How the laboratory can help

Quest Diagnostics and Cleveland HeartLab^® provides tests to assist in the assessment and care of patients who are at increased risk for severe outcomes from COVID-19.

1. If ordering through Cleveland HeartLab (CHL) use the following test order codes: Myeloperoxidase (MPO) (C133), ADMA/SDMA (C301), Apolipoprotein B (ApoB) (C123), Lipid panel (C906), Insulin Resistance Panel with Score (1388), Hemoglobin A1C (HbA1c) (C145)
2. Panel components may be ordered separately. For CHL panel components: Cholesterol, Total (C117), HDL Cholesterol (C118), Triglycerides (C119), Insulin (C146), C-Peptide (C136). For Quest panel components: Cardio IQ^® Cholesterol, Total (91717), Cardio IQ^® HDL Cholesterol (91719), Cardio IQ^® Triglycerides (91718), Insulin, Intact, LC/MS/MS (93103), C-Peptide (372)

Biomarker testing of vascular inflammation provides critical insight

A biomarker assessment of specific vascular inflammation markers associated with risk can help you identify patients who have vulnerable plaque and who may benefit from preventive care and risk factor mitigation.

Understanding a patient’s prior cardiovascular risk profile will help you identify those patients in need of more aggressive management in order to optimize their outcome should they become exposed to COVID-19 or seasonal flu.

Helping you identify those most at risk

Quest Diagnostics COVID-19 antibody testing and biomarker testing helps provide critical insight into elevated cardiovascular risk.

Ordering from Quest Diagnostics

Ordering from Cleveland HeartLab^®

• CPT codes are based on American Medical Association guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.