AHA News : Researchers take a closer look at what COVID-19 does to the heart

30 Jan 2023 • According to a new study, published last Friday in the American Heart Association journal Circulation, people hospitalized with COVID-19 may have an increased risk for heart damage, but not so much the type of inflammation previous research suggested. Early in the pandemic, several studies suggested many COVID-19 survivors experienced heart damage even if they didn't have underlying heart disease and weren't sick enough to be hospitalized. The new study examined the nature and extent of the heart damage and inflammation in the sickest people with COVID-19.

Researchers looked at 342 COVID-19 patients with high levels of the protein troponin in 25 United Kingdom hospitals between June 2020 and March 2021. Participants were compared with two control groups, one with 64 people hospitalized with COVID-19 who had normal troponin levels, and a second group of 113 people of a similar age, sex and cardiovascular health but without COVID-19 or elevated troponin levels who had not been in the hospital. All hospitalized patients had a magnetic resonance imaging scan within 28 days of discharge. Non-hospitalized participants also received an MRI.

The study found that 61% of people hospitalized with COVID-19 who had high troponin levels had heart abnormalities including scarring from myocardial infarction, or from microinfarction, which the study's lead author, John Greenwood, called "small areas of scar." That was almost twice as high as hospitalized COVID-19 participants with normal troponin (36%) and those without COVID-19 who had normal troponin (31%).

But when it came to suspected myocarditis, researchers found the prevalence was 6.7% in participants with COVID-19 and elevated troponin, compared to 1.7% in those without. That's much lower than seen in previous studies, according to Greenwood, a cardiology professor at Leeds Institute for Cardiovascular and Diabetes Research in England and a cardiologist at Leeds Teaching Hospitals NHS Trust.

"Several smaller past studies raised a lot of concern about myocarditis. But this more rigorous national study of hospitalized patients with troponin elevation shows clearly that this isn't predominantly a condition of a viral myocarditis, but more of a condition of infarction and microinfarction," he said. "This is really important information for clinicians who have the challenge of trying to understand why troponin levels are elevated so they can tailor the appropriate treatment options." Source: AHA News | Read full story

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