Heart damage was found in more than half of a group of hospitalized COVID-19 patients after they were discharged, according to a new British study.
The study included 148 patients who were treated for severe COVID-19 at six hospitals in London. The patients all had raised levels of a protein called troponin, which is released into the blood when the heart muscle is injured.
Many hospitalized COVID-19 patients have elevated troponin levels when they’re critically ill and the body mounts an exaggerated immune response to the infection, the researchers noted.
MRI scans of the patients’ hearts were conducted at least one month after discharge. The scans showed that 54% had damage to their hearts.
Damage included inflammation of the heart muscle, scarring or death of heart tissue, and restricted blood supply to the heart. Some patients had combinations of all three types of damage, the findings showed.
The report was published Feb. 18 in the European Heart Journal.
“Raised troponin levels are associated with worse outcomes in COVID-19 patients. Patients with severe COVID-19 disease often have pre-existing heart-related health problems including diabetes, raised blood pressure and obesity,” said study co-author Marianna Fontana. She is a professor of cardiology at University College London.
“During severe COVID-19 infection, however, the heart may also be directly affected. Unpicking how the heart can become damaged is difficult, but MRI scans of the heart can identify different patterns of injury, which may enable us to make more accurate diagnoses and to target treatments more effectively,” Fontana said in a journal news release.
About one-third of the patients had been on a ventilator in the intensive care unit.
Some of the heart damage in the patients may have been present before they contracted COVID-19. But the MRI scans showed some was new and likely caused by COVID-19, according to Fontana.
“Importantly, the pattern of damage to the heart was variable, suggesting that the heart is at risk of different types of injury. While we detected only a small amount of ongoing injury, we saw injury to the heart that was present even when the heart’s pumping function was not impaired and might not have been picked up by other techniques,” Fontana said.
In the most severe cases, she added, concerns exist that this injury may increase the risks of heart failure in the future, but more investigation is needed.
Fontana said that the study findings offer two opportunities. One is to find ways of preventing the injury in the first place. “From some of the patterns we have seen, blood clotting may be playing a role, for which we have potential treatments,” she noted.
“Secondly, detecting the consequences of injury during convalescence may identify subjects who would benefit from specific supporting drug treatments to protect heart function over time,” Fontana said.
The American Heart Association has more on COVID-19.
SOURCE: European Heart Journal, news release, Feb. 18, 2021