ANI |
Updated: Feb 20, 2021 22:52 IST
Washington [US], February 20 (ANI): Through a clinical study published in the European Journal of Heart, scientists claim that about half of the patients diagnosed have had heart damage. study after being hospitalized with true COVID-19 and showed high levels of a protein called troponin.
The injury was detected by magnetic resonance imaging (MRI) scans at least a month after their release, according to new findings published Thursday in the European Heart Journal.
Damage includes inflammation of the heart muscle (myocarditis), scarring or death of a heart attack (infarction), a restricted blood supply to the heart (ischemia) and a combination of all three.
The study of 148 patients from six emergency hospitals in London is the largest study to date to examine COVID-19 patients who had elevated troponin levels revealing a potential heart problem .
Troponin is released into the bloodstream when the heart muscle is injured. Elevated levels can occur when an artery is blocked or there is inflammation in the heart. Many hospitalized patients with COVID-19 have elevated troponin levels at the stage of the acute illness, when the body triggers an extreme immune response to the disease.
Troponin levels were elevated in all patients in this study followed by MRI scans of the heart after discharge to understand the causes and extent of the damage.
Professor Marianna Fontana, a professor of cartography at University College London (UK), who led the research with Dr. Graham Cole, consultant cardiologist at Imperial College London: “Elevated troponin levels are associated with worse outcomes in COVID-19 patients. Patients with severe COVID-19 disease often have heart-related health problems. including diabetes, elevated blood pressure, and obesity. “
“During severe COVID-19 disease, however, the heart can be directly affected. It is difficult to know how the heart could be damaged, but MRI scans of the heart can make a difference identify injury patterns, which may allow us to make more accurate diagnoses and focus on more effective treatments, “Fontana said.
The researchers studied COVID-19 patients discharged up to June 2020 from six hospitals across three NHS London trusts: Royal London NHS Foundation Trust, Imperial College Healthcare NHS Trust, and College Hospital NHS Foundation Trust University of London.
Patients with abnormal troponin levels after discharge were offered an MRI scan of the heart and compared with those from a control group of non-COVID-19 patients, as well as from 40 free -healthy healthy.
“The surviving COVID-19 patients were very ill; they all needed hospitalization and all had a troponin booster, with about one in three having been on an airway in the intensive care unit, “said Dr. Fontana.
“We found evidence of high levels of heart muscle injury seen on the scans a month or two after their release. While some of this may have occurred before, an MRI scan shows that some of them new, and apparently caused by COVID- 19. Importantly, the pattern of heart damage was variable, suggesting that the heart is at risk from different types of injuries, ”he said.
“Although we found very few persistent injuries, we did see heart injuries that were present even when the heart pumping was not weakened and may not have been picked up by other means. In the worst cases, There are concerns that this injury could increase the risks of heart failure in the future, but more work is needed to investigate this further, “he continued.
The left ventricle function of the heart, the chamber responsible for pumping oxygenated blood to all parts of the body, was normal in 89 percent of the 148 patients but heart muscle rupture or injury was present in 80 patients (54 per cent).
The pattern of scarring or thin lesions arose from inflammation in 39 patients (26 percent), ischemic heart disease, which includes infarction or ischemia, in 32 patients (22 percent), or both in nine patients (6 percent). A dozen patients appeared to have persistent heart inflammation (8 percent).
Dr. said. Fontana: “Inflammation-related injury and scarring of the heart are common in COVID-19 patients with elevated troponin discharge from hospital, but it is mild and has little effect on its function. heart.
“These decisions give us two opportunities: first, to find ways to prevent the injury in the first place, and from some of the patterns we have seen, bleeding may be role play, which we may have remedies.
Second, by detecting the effects of injury during recovery, it could identify subjects who would benefit from specific drug supportive therapies to protect heart activity over time. “
The findings of the study are limited by the nature of patient selection and included only those who survived coronavirus infection who required hospital admission.
“The convalescent patients in this study had severe COVID-19 infection and our results say nothing about what happens to those who are not hospitalized with COVID, or those who are hospitalized but without elevated troponin.
The findings highlight potential ways to identify patients with higher or lower risk and suggest strategies that could improve outcomes. More work is needed, and MRI scans of the heart have shown its usefulness in studying patients with troponin elevation, ”concluded Dr. Fontana (ANI).