Study Finds 78% of Recovered COVID-19 Patients Develop Heart Conditions

Study published in the medical journal JAMA Network reveals cardiovascular effects in recovered coronavirus patients

Coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. Inpatient case reports suggest that the disease prominently affects the cardiovascular system, but the overall impact remains unknown. Until now, the main emphasis of research has been on acute respiratory complications, especially in critically ill patients.

To better understand the prevalence, extent, and type of cardiovascular sequelae, a group of researchers at Frankfurt University Hospital proactively examined patients with a recent documented COVID-19 infection using highly standardized serological markers of cardiac injury and in-depth imaging. with cardiovascular magnetic resonance (CMR).

In the prospective observational cohort study, published in the JAMA Network, 100 newly recovered patients from COVID-19 Registry disease were identified from the same hospital between April and June 2020. All participants were considered eligible after a minimum of 2 weeks from the original diagnosis if they had resolution of respiratory symptoms and negative results in a swab test at the end of the isolation period.

Findings revealed by research demonstrated cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), regardless of pre-existing conditions, severity, and overall course of acute disease and time since original diagnosis. . These findings indicate the need for continued investigation of the long-term cardiovascular consequences of COVID-19.

Of the 100 patients included, 53 (53%) were men, and the median age was 49 (45-53) years. The median time interval between COVID-19 diagnosis and study was 71 (64-92) days. Of the 100 recently recovered COVID-19 patients, 67 (67%) recovered at home, while 33 (33%) required hospitalization. Demographic characteristics, cardiac blood markers, and cardiovascular magnetic resonance imaging (CMR) were obtained. Comparisons were made with healthy age and sex control groups of healthy volunteers and patients with risk factors.

Comparisons were made with control groups of normotensive adults who did not take cardiac medications, had normal cardiac volumes and functions, and had no evidence of scarring. Comparisons were also made with patients with risk factors for age, sex, hypertension, diabetes, smoking, known coronary heart disease, or comorbidities.

A total of 78 patients who recovered from COVID-19 infection (78%) had cardiovascular involvement as detected by standardized CMR, regardless of pre-existing conditions, severity, and overall course of COVID-19 presentation, time from original diagnosis or presence of cardiac symptoms. The most prevalent abnormality was myocardial inflammation, detected in 60 recently recovered patients from COVID-19 (60%), followed by regional scarring and pericardial enhancement.

To the best of our knowledge, this is the first prospective report on a cohort of unselected patients with recent COVID-19 infection identified at a local testing center who voluntarily underwent an assessment of cardiac compromise with CMR. "The results of our study provide important information on the prevalence of cardiovascular involvement in the initial stage of convalescence. Our findings demonstrate that participants with a relative shortage of pre-existing cardiovascular conditions and with a mostly home recovery had frequent cardiac inflammatory involvement, which was similar to the hospitalized subgroup with respect to severity and scope, "the researchers caution.

However, specialists recognize some limitations: “The findings are not validated for use in pediatric patients 18 years of age or younger. They also do not represent patients during acute infection with COVID-19 or those who are completely asymptomatic with the disease. Several patients within our cohort had new or persistent symptoms, increasing the likelihood of positive CMR findings. Results data is still pending. The image sequences used in this study have been validated, standardized, and locked for use in multicenter settings. Using other imaging protocols, sequence parameters, or postprocessing approaches can yield different results. ”