Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry
BACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical...
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| author | Frank Cañón-Estrada Juan Andrés Muñoz-Ordoñez Manuela Escalante‐Forero Yorlany Rodas Andrea Alejandra Arteaga-Tobar Valeria Azcárate-Rodríguez Eduardo Perna Iván Mendoza Fernando Wyss José Luis Barisani Mario Speranza Walter Alarco Juan Carlos Barrera Ortega Andrés Ulate Jessica Mercedes Daniel Quesada Paola Oliver Andrea Valencia‐Orozco Mario Miguel Barbosa Hoover León-Giraldo Noel Flórez Juan Esteban Gómez‐Mesa María Lorena Coronel Alejandra Christen Paula Alexandra Silva Juan Martín Brunialti Pedro Vellosa Schwartzmann Luis Carlos Santana Passos Estêvão Lanna Figueiredo Carlos Eduardo Lucena Montenegro Franco Appiani Florit Ricardo Enrique Larrea Gómez Fernando Verdugo Thomas Iván Criollo Ricardo Ramírez Víctor Rossel Julián Lugo Hugo Fernández María José Sanjinés Rodríguez Andrés F. Buitrago Noel Flórez Juan Isaac Ortíz William Millán Orozco Clara Saldarriaga Daniel Quesada Sylvia Sandoval Liliana Patricia Cárdenas Aldaz Marlon Aguirre Fei Chong Armando Alvarado Daniel Sierra Alexander Romero Miguel Quintana Felipe Nery Gervacio Fernández R. Correa Francisco Chávez Sol Sol Wilbert German Yabar Galindo Claudia Almonte César J. Herrera Igor Morr Eglee Castillo |
| author_browse | Alejandra Christen Alexander Romero Andrea Alejandra Arteaga-Tobar Andrea Valencia‐Orozco Andrés F. Buitrago Andrés Ulate Armando Alvarado Carlos Eduardo Lucena Montenegro Clara Saldarriaga Claudia Almonte César J. Herrera Daniel Quesada Daniel Sierra Eduardo Perna Eglee Castillo Estêvão Lanna Figueiredo Fei Chong Felipe Nery Gervacio Fernández Fernando Verdugo Thomas Fernando Wyss Francisco Chávez Sol Sol Franco Appiani Florit Frank Cañón-Estrada Hoover León-Giraldo Hugo Fernández Igor Morr Iván Criollo Iván Mendoza Jessica Mercedes José Luis Barisani Juan Andrés Muñoz-Ordoñez Juan Carlos Barrera Ortega Juan Esteban Gómez‐Mesa Juan Isaac Ortíz Juan Martín Brunialti Julián Lugo Liliana Patricia Cárdenas Aldaz Luis Carlos Santana Passos Manuela Escalante‐Forero Mario Miguel Barbosa Mario Speranza Marlon Aguirre María José Sanjinés Rodríguez María Lorena Coronel Miguel Quintana Noel Flórez Paola Oliver Paula Alexandra Silva Pedro Vellosa Schwartzmann R. Correa Ricardo Enrique Larrea Gómez Ricardo Ramírez Sylvia Sandoval Valeria Azcárate-Rodríguez Víctor Rossel Walter Alarco Wilbert German Yabar Galindo William Millán Orozco Yorlany Rodas |
| author_facet | Frank Cañón-Estrada Juan Andrés Muñoz-Ordoñez Manuela Escalante‐Forero Yorlany Rodas Andrea Alejandra Arteaga-Tobar Valeria Azcárate-Rodríguez Eduardo Perna Iván Mendoza Fernando Wyss José Luis Barisani Mario Speranza Walter Alarco Juan Carlos Barrera Ortega Andrés Ulate Jessica Mercedes Daniel Quesada Paola Oliver Andrea Valencia‐Orozco Mario Miguel Barbosa Hoover León-Giraldo Noel Flórez Juan Esteban Gómez‐Mesa María Lorena Coronel Alejandra Christen Paula Alexandra Silva Juan Martín Brunialti Pedro Vellosa Schwartzmann Luis Carlos Santana Passos Estêvão Lanna Figueiredo Carlos Eduardo Lucena Montenegro Franco Appiani Florit Ricardo Enrique Larrea Gómez Fernando Verdugo Thomas Iván Criollo Ricardo Ramírez Víctor Rossel Julián Lugo Hugo Fernández María José Sanjinés Rodríguez Andrés F. Buitrago Noel Flórez Juan Isaac Ortíz William Millán Orozco Clara Saldarriaga Daniel Quesada Sylvia Sandoval Liliana Patricia Cárdenas Aldaz Marlon Aguirre Fei Chong Armando Alvarado Daniel Sierra Alexander Romero Miguel Quintana Felipe Nery Gervacio Fernández R. Correa Francisco Chávez Sol Sol Wilbert German Yabar Galindo Claudia Almonte César J. Herrera Igor Morr Eglee Castillo |
| author_sort | Frank Cañón-Estrada |
| collection | Producción científica |
| description | BACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes. METHODS: This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021. RESULTS: Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality. CONCLUSIONS: In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/1354 |
| institution | UPeU |
| language | English |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/13542026-10-30T16:15:38ZBiochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registryFrank Cañón-EstradaJuan Andrés Muñoz-OrdoñezManuela Escalante‐ForeroYorlany RodasAndrea Alejandra Arteaga-TobarValeria Azcárate-RodríguezEduardo PernaIván MendozaFernando WyssJosé Luis BarisaniMario SperanzaWalter AlarcoJuan Carlos Barrera OrtegaAndrés UlateJessica MercedesDaniel QuesadaPaola OliverAndrea Valencia‐OrozcoMario Miguel BarbosaHoover León-GiraldoNoel FlórezJuan Esteban Gómez‐MesaMaría Lorena CoronelAlejandra ChristenPaula Alexandra SilvaJuan Martín BrunialtiPedro Vellosa SchwartzmannLuis Carlos Santana PassosEstêvão Lanna FigueiredoCarlos Eduardo Lucena MontenegroFranco Appiani FloritRicardo Enrique Larrea GómezFernando Verdugo ThomasIván CriolloRicardo RamírezVíctor RosselJulián LugoHugo FernándezMaría José Sanjinés RodríguezAndrés F. BuitragoNoel FlórezJuan Isaac OrtízWilliam Millán OrozcoClara SaldarriagaDaniel QuesadaSylvia SandovalLiliana Patricia Cárdenas AldazMarlon AguirreFei ChongArmando AlvaradoDaniel SierraAlexander RomeroMiguel QuintanaFelipe Nery Gervacio FernándezR. CorreaFrancisco Chávez Sol SolWilbert German Yabar GalindoClaudia AlmonteCésar J. HerreraIgor MorrEglee CastilloMedicineAngiologyInternal medicineBiomarkerProcalcitoninPulmonary embolismIntensive care unitFerritinPopulationHeart failureCardiologySepsisEnvironmental healthBiochemistryChemistryMedicineAngiologyInternal medicineBiomarkerProcalcitoninPulmonary embolismIntensive care unitFerritinPopulationHeart failureCardiologySepsisCOVID-19 bloodCOVID-19 bloodCOVID-19 bloodCOVID-19 bloodCOVID-19 bloodCOVID-19 bloodCOVID-19 diagnosisCOVID-19 diagnosisCOVID-19 diagnosisCOVID-19 diagnosisCOVID-19 diagnosisCOVID-19 diagnosisCOVID-19 mortalityCOVID-19 mortalityCOVID-19 mortalityCOVID-19 mortalityCOVID-19 mortalityCOVID-19 mortalityCOVID-19 epidemiologyCOVID-19 epidemiologyCOVID-19 epidemiologyCOVID-19 epidemiologyCOVID-19 epidemiologyCOVID-19 epidemiologyCOVID-19 therapyCOVID-19 therapyCOVID-19 therapyCOVID-19 therapySARS-CoV-2SARS-CoV-2SARS-CoV-2SARS-CoV-2SARS-CoV-2SARS-CoV-2AgedAgedAgedAgedAgedAgedC-Reactive Protein analysisC-Reactive Protein analysisC-Reactive Protein metabolismC-Reactive Protein metabolismFemaleFemaleFemaleFemaleFemaleFemaleFerritins bloodFerritins bloodFibrin Fibrinogen Degradation Products analysisFibrin Fibrinogen Degradation Products analysisHospitalizationHospitalizationHospitalizationHospitalizationHumansHumansHumansHumansHumansHumansLatin America epidemiologyLatin America epidemiologyLatin America epidemiologyLatin America epidemiologyLatin America epidemiologyLatin America epidemiologyMaleMaleMaleMaleMaleMaleMiddle AgedMiddle AgedMiddle AgedMiddle AgedMiddle AgedMiddle AgedPrognosisPrognosisPrognosisPrognosisPrognosisPrognosisProspective StudiesProspective StudiesProspective StudiesProspective StudiesProspective StudiesProspective StudiesRegistriesRegistriesRegistriesRegistriesRegistriesRegistriesRisk FactorsRisk FactorsRisk FactorsRisk FactorsRisk FactorsRisk FactorsSex FactorsSex FactorsSex FactorsSex FactorsSex FactorsSex FactorsBiomarkers bloodBiomarkers bloodBiomarkers bloodBiomarkers bloodBiomarkers bloodBiomarkers bloodCluster AnalysisCluster AnalysisCluster AnalysisCluster AnalysisCluster AnalysisCluster AnalysisCaribbean Region epidemiologyCaribbean Region epidemiologyCaribbean Region epidemiologyCaribbean Region epidemiologyCaribbean Region epidemiologyCaribbean Region epidemiologyHealth Sciences Medicine Infectious Diseases COVID-19 Clinical Research StudiesHealth Sciences Medicine Neurology Long-Term Effects of COVID-19Health Sciences Medicine Infectious Diseases SARS-CoV-2 and COVID-19 ResearchBACKGROUND: The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. OBJECTIVE: To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes. METHODS: This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021. RESULTS: Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality. CONCLUSIONS: In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.Articlehttps://pubmed.ncbi.nlm.nih.gov/40045210https://bmccardiovascdisord.biomedcentral.com/counter/pdf/10.1186/s12872-025-04565-3https://doi.org/10.1186/s12872-025-04565-310.1186/s12872-025-04565-3https://hdl.handle.net/20.500.15037/1354W4408157960enBMC Cardiovascular Disorders1471-22612025-03-052026-06-13T09:54:45Z2026-06-13T09:54:45Z |
| spellingShingle | Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis Environmental health Biochemistry Chemistry Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 therapy COVID-19 therapy COVID-19 therapy COVID-19 therapy SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 Aged Aged Aged Aged Aged Aged C-Reactive Protein analysis C-Reactive Protein analysis C-Reactive Protein metabolism C-Reactive Protein metabolism Female Female Female Female Female Female Ferritins blood Ferritins blood Fibrin Fibrinogen Degradation Products analysis Fibrin Fibrinogen Degradation Products analysis Hospitalization Hospitalization Hospitalization Hospitalization Humans Humans Humans Humans Humans Humans Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Male Male Male Male Male Male Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Prognosis Prognosis Prognosis Prognosis Prognosis Prognosis Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Registries Registries Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Health Sciences Medicine Neurology Long-Term Effects of COVID-19 Health Sciences Medicine Infectious Diseases SARS-CoV-2 and COVID-19 Research Frank Cañón-Estrada Juan Andrés Muñoz-Ordoñez Manuela Escalante‐Forero Yorlany Rodas Andrea Alejandra Arteaga-Tobar Valeria Azcárate-Rodríguez Eduardo Perna Iván Mendoza Fernando Wyss José Luis Barisani Mario Speranza Walter Alarco Juan Carlos Barrera Ortega Andrés Ulate Jessica Mercedes Daniel Quesada Paola Oliver Andrea Valencia‐Orozco Mario Miguel Barbosa Hoover León-Giraldo Noel Flórez Juan Esteban Gómez‐Mesa María Lorena Coronel Alejandra Christen Paula Alexandra Silva Juan Martín Brunialti Pedro Vellosa Schwartzmann Luis Carlos Santana Passos Estêvão Lanna Figueiredo Carlos Eduardo Lucena Montenegro Franco Appiani Florit Ricardo Enrique Larrea Gómez Fernando Verdugo Thomas Iván Criollo Ricardo Ramírez Víctor Rossel Julián Lugo Hugo Fernández María José Sanjinés Rodríguez Andrés F. Buitrago Noel Flórez Juan Isaac Ortíz William Millán Orozco Clara Saldarriaga Daniel Quesada Sylvia Sandoval Liliana Patricia Cárdenas Aldaz Marlon Aguirre Fei Chong Armando Alvarado Daniel Sierra Alexander Romero Miguel Quintana Felipe Nery Gervacio Fernández R. Correa Francisco Chávez Sol Sol Wilbert German Yabar Galindo Claudia Almonte César J. Herrera Igor Morr Eglee Castillo Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title | Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title_full | Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title_fullStr | Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title_full_unstemmed | Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title_short | Biochemical differences based on sex and clusters of biomarkers in patients with COVID-19: analysis from the CARDIO COVID 19–20 registry |
| title_sort | biochemical differences based on sex and clusters of biomarkers in patients with covid 19 analysis from the cardio covid 19 20 registry |
| topic | Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis Environmental health Biochemistry Chemistry Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 therapy COVID-19 therapy COVID-19 therapy COVID-19 therapy SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 Aged Aged Aged Aged Aged Aged C-Reactive Protein analysis C-Reactive Protein analysis C-Reactive Protein metabolism C-Reactive Protein metabolism Female Female Female Female Female Female Ferritins blood Ferritins blood Fibrin Fibrinogen Degradation Products analysis Fibrin Fibrinogen Degradation Products analysis Hospitalization Hospitalization Hospitalization Hospitalization Humans Humans Humans Humans Humans Humans Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Male Male Male Male Male Male Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Prognosis Prognosis Prognosis Prognosis Prognosis Prognosis Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Registries Registries Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Health Sciences Medicine Neurology Long-Term Effects of COVID-19 Health Sciences Medicine Infectious Diseases SARS-CoV-2 and COVID-19 Research |
| topic_facet | Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis Environmental health Biochemistry Chemistry Medicine Angiology Internal medicine Biomarker Procalcitonin Pulmonary embolism Intensive care unit Ferritin Population Heart failure Cardiology Sepsis COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 blood COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 diagnosis COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 mortality COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 epidemiology COVID-19 therapy COVID-19 therapy COVID-19 therapy COVID-19 therapy SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 SARS-CoV-2 Aged Aged Aged Aged Aged Aged C-Reactive Protein analysis C-Reactive Protein analysis C-Reactive Protein metabolism C-Reactive Protein metabolism Female Female Female Female Female Female Ferritins blood Ferritins blood Fibrin Fibrinogen Degradation Products analysis Fibrin Fibrinogen Degradation Products analysis Hospitalization Hospitalization Hospitalization Hospitalization Humans Humans Humans Humans Humans Humans Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Latin America epidemiology Male Male Male Male Male Male Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Middle Aged Prognosis Prognosis Prognosis Prognosis Prognosis Prognosis Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Registries Registries Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Risk Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Sex Factors Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Biomarkers blood Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Cluster Analysis Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Caribbean Region epidemiology Health Sciences Medicine Infectious Diseases COVID-19 Clinical Research Studies Health Sciences Medicine Neurology Long-Term Effects of COVID-19 Health Sciences Medicine Infectious Diseases SARS-CoV-2 and COVID-19 Research |
| url | https://pubmed.ncbi.nlm.nih.gov/40045210 https://bmccardiovascdisord.biomedcentral.com/counter/pdf/10.1186/s12872-025-04565-3 https://doi.org/10.1186/s12872-025-04565-3 https://hdl.handle.net/20.500.15037/1354 |
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