- A new study finds that approximately 50% of people hospitalized with severe COVID-19 have evidence of heart damage.
- The researchers investigated patients with COVID-19 who received medical discharge by June 2020 from six UK-based hospitals. The study examined 148 patients.
- Research
published last July it was found that people experiencing a mild form of COVID-19 could develop heart problems.
Millions of people in the United States have contracted SARS-CoV-2, the virus that causes COVID 19, and many people return to health within weeks of falling ill. But for some patients, the after-effects of the disease can cause long-term health problems.
A new study found that approximately 50 percent of people hospitalized with severe COVID-19 will present evidence of heart damage, even months after recovering from the disease.
Patients with abnormal troponin levels were offered an MRI of the heart after discharge. The results were compared with those of a control group of patients who did not have COVID-19 and another 40 healthy volunteers.
The researchers investigated patients with COVID-19 who received medical discharge by June 2020 from six UK-based hospitals.
The study examined 148 people and is the largest to investigate patients recovering with COVID-19 who have elevated troponin levels. Elevated troponin indicates possible heart problems.
“Troponin is basically a measure of muscle damage,” Dr. Andrew M. Freeman, a cardiologist at Colorado’s National Jewish Health, told Healthline. “So when the heart muscle dies, like during a heart attack or a marked inflammation, and for whatever reason, the heart muscle cells actually burst, they release an enzyme called troponin.”
Freeman explained that when someone arrives in the emergency room with chest pains, hospital staff usually test their troponin on their blood to see if there is a heart attack or damage to the heart muscles.
“Increased troponin levels are associated with worse outcomes in patients with COVID-19,” said Dr. Marianna Fontana, co-researcher in the study and professor of cardiology at University College London, in a statement.
During severe COVID-19 disease, the heart can be directly affected, Fontana said.
“Finding out how heart damage can be damaged is difficult,” he continued. “But the MRI of the heart can identify different patterns of injury, which can allow us to make more accurate diagnoses and target treatments more effectively.”
Research
Researchers in the study used cardiac MRI to examine the hearts of 100 German nationals who recovered from COVID-19.
Of these participants, 78 showed heart problems and 60 had ongoing cardiac muscle inflammation.
According to the study, the results were independent of the time elapsed after an original diagnosis, of pre-existing conditions, or of the severity and general course of the disease.
What makes the findings difficult to specifically associate with COVID-19 is that people most at risk for severe COVID are those with chronic medical conditions that are often specifically related to the heart. Fontana said these conditions include diabetes, high blood pressure and obesity.
Dr. Rachel-Maria Brown Talaska, director of inpatient 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 often have coronary heart disease and congestive heart attack.
“Most patients hospitalized with COVID-19 have a chronic medical condition,” he said.
According to the study, 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.
However, healing or injury to the heart muscle itself was present in approximately half of the participants.
The pattern of scarring or injury originated from inflammation in 39 patients and ischemic heart disease, including heart attack (death of heart tissue), in 32 patients, or both in 9 patients. Twelve participants showed evidence of ongoing cardiac inflammation.
“Injuries related to inflammation and heart scarring are common in patients with COVID-19 elevated troponin discharged from the hospital,” Fontana said in a statement. “But (it has) a limited extent and has few consequences for heart function.”
He concluded that “more work is needed to investigate this further.”
According to Dr. Michael Goyfman, director of clinical cardiology at Long Island Jewish Forest Hills in New York, there is no evidence that COVID-19 causes more heart damage than other infections.
“The predominance of evidence so far shows that COVID doesn’t 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, it can also cause it. The rate is probably similar to other infections.
The numbers are rising because “COVID is so common,” Goyfman continued. “There is no evidence that COVID triggers an excess of heart attacks than other viral diseases.”
Freeman believes the number of people in the study was too small to provide a clear picture of how COVID-19 could affect the heart.
“It’s always good to see what others see and post that data to share knowledge with the world,” Freeman said. “But I would agree it’s a relatively small sample size.”
He noted that if you look at the hundreds of thousands of people who had COVID-19, even in the United States, “you know that a sample of 148 doesn’t provide you with a huge amount of information on trends.”
According to a new UK study, half of study participants hospitalized with severe COVID-19 have heart damage.
Of 148 participants, the researchers found cardiac damage caused by inflammation in 39 of these patients, but noted that most participants had chronic disease before COVID-19.
Experts say the small size of the study and the lack of evidence indicating that COVID-19 was directly responsible for heart damage are significant limitations to the results of the study.