Heart damage seen in 50% of people hospitalized with COVID-19

Patients with abnormal troponin levels were offered an MRI of their heart after discharge. The results were compared with those of a control group of patients without COVID-19 and 40 other healthy volunteers.

Researchers have been investigating COVID-19 patients who were referred for care until June 2020 from six UK-based hospitals.

The study examined 148 people and is the largest one studying recovering patients with COVID-19 who have high troponin levels. High troponin indicates possible heart problems.

“Troponin is basically a measure of damage to the heart muscle,” Dr. Andrew M. Freeman, cardiologist at National Jewish Health in Colorado, told Healthline. “So when the heart muscle dies, like in a heart attack or marked inflammation, and for some reason the heart muscle cells actually burst, they release an enzyme called troponin.

Freeman explained that when a person presents to the emergency room with chest pain, hospital staff often test their blood for troponin to see if there has been a heart attack or damage to the heart muscle.

“Elevated troponin levels are associated with worse outcomes in COVID-19 patients,” said Dr Marianna Fontana, co-principal investigator of the study and professor of cardiology at University College London, in a statement.

During severe illness with COVID-19, the heart can be directly affected, Fontana said.

“It’s hard to see how the heart can be damaged,” she continued. “But MRIs of the heart can identify different patterns of injury, which can allow us to make more precise diagnoses and target treatments more effectively.”

Search published Last July, JAMA Cardiology discovered that people with even a mild form of COVID-19 could develop heart problems.

Researchers in the study used cardiac MRI to examine the hearts of 100 German nationals who have recovered from COVID-19.

Of these participants, 78 had heart problems and 60 had continued inflammation of the heart muscle.

According to the study, the results were independent of time after initial diagnosis, pre-existing conditions, or the severity and general course of the disease.

What makes the results difficult to associate specifically with COVID-19 is that those most at risk for severe COVID are those with chronic illness that is often specifically related to the heart. Fontana said these conditions include diabetes, high blood pressure, and obesity.

Dr Rachel-Maria Brown Talaska, director of hospital cardiac services at Lenox Hill Hospital in New York City, said that in addition to the pre-existing conditions specified by Fontana, people with severe COVID-19 also tend to have coronary artery disease. and congestive. heart failure.

“The majority of hospitalized patients with COVID-19 suffer from a chronic illness,” she said.

The left ventricle of the heart, the chamber responsible for pumping oxygenated blood to all parts of the body, was normal in nearly 90% of the 148 study participants, according to the study.

However, scarring or injury to the heart muscle itself was present in about half of the participants.

The scarring or injury pattern was caused by inflammation in 39 patients and ischemic heart disease, including infarction (death of heart tissue), in 32 patients, or both in 9 patients. Twelve participants showed signs of continued heart inflammation.

“Injuries related to inflammation and scarring of the heart are common in COVID-19 patients with troponin elevation discharged from hospital,” Fontana said in a statement. “But (it) is of limited scope and has little impact on the functioning of the heart.”

She concluded that “more work is needed to explore this issue further.”

According to Dr. Michael Goyfman, director of clinical cardiology at Long Island Jewish Forest Hills in New York City, there is no evidence that COVID-19 causes more heart damage than other infections.

“The prevalence of evidence to date shows that COVID does not really cause excessive heart damage compared to other infections,” he said. “Viral infections, in general, can cause inflammation of the heart, and since COVID is a viral infection, so can it. The rate is probably similar to that of other infections. “

The numbers are increased because “COVID is so prevalent,” Goyfman continued. “There is no evidence that COVID triggers excessive heart attacks compared to other viral illnesses.”

Freeman believes the number of people participating in the study was too small to give a clear picture of how COVID-19 could affect the heart.

“It’s always nice to see what other people see and to publish that data in order to share their knowledge with the world,” Freeman said. “But I agree that this is a relatively small sample.”

He noted that if you look at the hundreds of thousands of people who have had COVID-19, even in the United States, “you know that a sample of 148 doesn’t give you a huge amount of information on trends.”

New research from the UK finds half of study participants hospitalized with severe COVID-19 have heart damage.

Out of 148 participants, the researchers found heart damage caused by inflammation in 39 of these patients, but pointed out that most of the participants had chronic illness before COVID-19.

Experts say the small size of the study and the lack of evidence that COVID-19 was directly responsible for heart damage are significant limitations to the study’s results.