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Heart inflammation: A consequence of COVID?

Heart data concept. Copyright: tribalium123 / 123RF Stock Photo
Image credit: tribalium123 / 123RF

As the COVID-19 pandemic evolves, we learn more about the potential long-term health consequences of the disease. The impact on cardiac health is among the issues researchers have studied and research released earlier this week lends an insight into one potential ramification: heart inflammation.

Research published in JAMA Cardiology studied the cardiovascular magnetic imaging results of 100 adults, all of whom belonged to the University Hospital Frankfurt COVID-19 Registry in Germany. “In this cohort study including 100 patients recently recovered from COVID-19 identified from a COVID-19 test centre, cardiac magnetic resonance imaging revealed cardiac involvement in 78 patients (78 percent) and ongoing myocardial inflammation in sixty patients (sixty percent).” 

The findings are “independent of preexisting conditions, severity and overall course of the acute illness, and the time from the original diagnosis,” the researchers said. “The results of our study provide important insights into the prevalence of cardiovascular involvement in the early convalescent stage,” commented the study authors, led by Valentina O. Puntmann, M.D., PhD. of the University Hospital Frankfurt in Germany. “Our findings demonstrate that participants with a relative paucity of preexisting cardiovascular condition and with mostly home-based recovery had frequent cardiac inflammatory involvement, which was similar to the hospitalized subgroup with regards to severity and extent. 

“Our observations are concordant with early case reports in hospitalized patients showing a frequent presence of late gadolinium enhancement, diffuse inflammatory involvement, and significant rise of troponin T levels.” 

How heart health is affected by COVID-19 – the disease caused by infection with severe acute respiratory syndrome coronavirus 2, or simply the coronavirus – has been the subject of much speculation and study. Earlier, it was reported that COVID-19 patients in critical condition warranting admission to the intensive care unit (ICU) may be vulnerable to detrimental effects on their cardiovascular wellbeing. Research found that ICU admissions were ten times more likely than those not warranting intensive care to develop complications such as cardiac arrest and arrhythmia. 

In India, Dr S. Chatterjee, a senior internal medicine consultant at Apollo Hospital in Chennai, sounded the alarm on similar themes. Chaterjee said “I have seen patients developing myocarditis [inflammation of the heart tissue]. The degree could vary from mild to moderate, and it is the right side of the heart that is getting involved more than the left. Although none of the patients have become very serious with myocarditis, it is a feature we are seeing in follow-up patients.”

The JAMA Cardiology researchers acknowledge that their “study has limitations. The findings are not validated for the use in paediatric patients eighteen years and younger. They also do not represent patients during acute COVID-19 infection or those who are completely asymptomatic with COVID-19.” Therefore, they stated “need for ongoing investigation of the long-term cardiovascular consequences of COVID-19” as it pertains to issues such as heart inflammation. This is true of a country like India, one which already bears a significant burden of heart disease (it having been the country’s leading killer in 2016). As such, the impact of COVID-19 on heart health is an area in need of investigation. 

“Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)” can be accessed here.

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