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Heart Damage Found in More Than Half of COVID-19 Patients Discharged From Hospital
https://scitechdaily.com ^ | FEBRUARY 17, 2021 | By EUROPEAN SOCIETY OF CARDIOLOGY

Posted on 02/19/2021 8:29:03 AM PST by Red Badger

MRI scan of damaged heart. Blue means reduced blood flow, orange is good blood flow. In this figure the inferior part of the heart shows dark blue, so the myocardial blood flow is very reduced and the black and white angiography, which looks directly at the blood vessels, shows that the vessel which supplies the blood to this part of the heart is occluded. The 3 colored images are 3 different slices of the heart: the basal the mid and the apical slice. Credit: European Heart Journal

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Around 50% of patients who have been hospitalized with severe COVID-19 and who show raised levels of a protein called troponin have damage to their hearts. The injury was detected by magnetic resonance imaging (MRI) scans at least a month after discharge, according to new findings published today (February 18, 2021) in the European Heart Journal.[1]

Damage includes inflammation of the heart muscle (myocarditis), scarring or death of heart tissue (infarction), restricted blood supply to the heart (ischaemia) and combinations of all three.

The study of 148 patients from six acute hospitals in London is the largest study to date to investigate convalescing COVID-19 patients who had raised troponin levels indicating a possible problem with the heart.

Troponin is released into the blood when the heart muscle is injured. Raised levels can occur when an artery becomes blocked or there is inflammation of the heart. Many patients who are hospitalized with COVID-19 have raised troponin levels during the critical illness phase, when the body mounts an exaggerated immune response to the infection. Troponin levels were elevated in all the patients in this study who were then followed up with MRI scans of the heart after discharge in order to understand the causes and extent of the damage.

Professor Marianna Fontana, professor of cardiology at University College London (UK), who led the research together with Dr. Graham Cole, a consultant cardiologist at Imperial College London, said: “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. 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.”

The researchers investigated COVID-19 patients discharged up until June 2020 from six hospitals across three NHS London trusts: Royal Free London NHS Foundation Trust, Imperial College Healthcare NHS Trust and University College London Hospital NHS Foundation Trust. Patients who had abnormal troponin levels were offered an MRI scan of the heart after discharge and were compared with those from a control group of patients who had not had COVID-19, as well as from 40 healthy volunteers.

“The recovering COVID-19 patients had been very ill; all required hospitalization and all had troponin elevation, with around one in three having been on a ventilator in the intensive care unit,” said Prof. Fontana.

“We found evidence of high rates of heart muscle injury that could be seen on the scans a month or two after discharge. Whilst some of this may have been pre-existing, MRI scanning shows that some were new, and likely caused by COVID-19. 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. In the most severe cases, there are concerns that this injury may increase the risks of heart failure in the future, but more work is needed to investigate this further.”

The function of the heart’s left ventricle, the chamber that is responsible for pumping oxygenated blood to all parts of the body, was normal in 89% of the 148 patients but scarring or injury to the heart muscle was present in 80 patients (54%). The pattern of tissue scarring or injury originated from inflammation in 39 patients (26%), ischaemic heart disease, which includes infarction or ischaemia, in 32 patients (22%), or both in nine patients (6%). Twelve patients (8%) appeared to have ongoing heart inflammation.

Prof. Fontana said: “Injury relating to inflammation and scarring of the heart is common in COVID-19 patients with troponin elevation discharged from hospital, but is of limited extent and has little consequence for the heart’s function.

“These findings give us two opportunities: firstly, to find ways of preventing the injury in the first place, and from some of the patterns we have seen, blood clotting may be playing a role, for which we have potential treatments. 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.”

The findings of the study are limited by the nature of patient selection and included only those who survived a coronavirus infection that required hospital admission.

“The convalescent patients in this study had severe COVID-19 disease and our results say nothing about what happens to people who are not hospitalized with COVID, or those who are hospitalized but without elevated troponin. The findings indicate potential ways to identify patients at higher or lower risk and suggest potential strategies that may improve outcomes. More work is needed, and MRI scans of the heart have shown how useful it is in investigating patients with troponin elevation,” concluded Prof. Fontana.

The study is also the subject of a discussion between Prof. Fontana and Prof. Eike Nagel, at the Society for Cardiovascular Magnetic Resonance annual meeting on Friday 19 February, where it will be presented for the first time.[2] Prof. Nagel, director of the Centre for Cardiovascular Imaging at Deutsches Zentrum Für Herz-Kreislauf-Forschung (DZHK), Frankfurt, Germany, is the senior author on an earlier paper[3] that found ongoing heart problems in up to 78% of COVID-19 patients who were less sick and most of whom did not require admission to hospital.

References:

“Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance” by Tushar Kotecha et al., 18 February 2021, European Heart Journal. DOI: 10.1093/eurheartj/ehab075 Society for Cardiovascular Magnetic Resonance virtual scientific sessions 2021, 09.00-09.45 hrs Central Standard Time in USA (6 hours behind GMT): https://bit.ly/3oMn84t “Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)” by Valentina O. Puntmann, MD, PhD; M. Ludovica Carerj, MD; Imke Wieters, MD; Masia Fahim; Christophe Arendt, MD; Jedrzej Hoffmann, MD; Anastasia Shchendrygina, MD, PhD; Felicitas Escher, MD; Mariuca Vasa-Nicotera, MD; Andreas M. Zeiher, MD; Maria Vehreschild, MD and Eike Nagel, MD, 27 July 2021, JAMA Cardiology. DOI: 10.1001/jamacardio.2020.3557


TOPICS: Business/Economy; Education; Health/Medicine; Society
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1 posted on 02/19/2021 8:29:03 AM PST by Red Badger
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To: Red Badger

Does it show images of what it looked like before?


2 posted on 02/19/2021 8:30:19 AM PST by crusty old prospector
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To: Red Badger

Well, far more than half of Rona patients hospitalized are us old people. So I would not be surprise to see some heart damage. Especially when you consider that a major comorbidity is obesity.

So, basically, duh.


3 posted on 02/19/2021 8:30:22 AM PST by cuban leaf (We killed our economy and damaged our culture. In 2021 we will pine for the salad days of 2020.)
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To: Red Badger

And the damage done with those virus vaccines.


4 posted on 02/19/2021 8:31:07 AM PST by SkyDancer (Remember Ashli Babbitt!)
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To: crusty old prospector

I think my post after yours is along the same lines. They might as well say they show signs of aging and obesity.


5 posted on 02/19/2021 8:31:30 AM PST by cuban leaf (We killed our economy and damaged our culture. In 2021 we will pine for the salad days of 2020.)
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To: Red Badger

Also: what is their current O2 level?


6 posted on 02/19/2021 8:32:05 AM PST by SkyDancer (Remember Ashli Babbitt!)
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To: cuban leaf

Let’s not let logic ruin a good panic.


7 posted on 02/19/2021 8:33:15 AM PST by rdl6989 ( )
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To: Red Badger

The headline is deceiving.From the article:

Around 50% of patients who have been hospitalized with severe COVID-19 and who show raised levels of a protein called troponin have damage to their hearts.

OF COURSE those with high levels of troponin could have damage. That’s what they check to see when people come in with chest pain. Troponin and heart attacks go together.


8 posted on 02/19/2021 8:34:38 AM PST by ozarkgirl ( )
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To: Red Badger

“EUROPEAN SOCIETY OF CARDIOLOGY”

Hmmm


9 posted on 02/19/2021 8:34:52 AM PST by V_TWIN (Where's Hunter???)
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To: cuban leaf

Yeah, the majority of Covid patients in the hospital I work in a re elderly. I live in Ocean County, NJ where one out of three people is over the age of 70 but for the past few months we’ve been seeing a lot a people in their 30’s,40’s and 50’s too.

Most of them turn out to be ‘’high risk’’ which means it’s more likely just the flu.


10 posted on 02/19/2021 8:35:12 AM PST by jmacusa (Liberals. Too stupid to be idiots.)
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To: Red Badger

InB4 “they were all 21 year old triathletes.”


11 posted on 02/19/2021 8:35:26 AM PST by cdcdawg (“we have to bring these people in.”)
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To: crusty old prospector

You asked the right question, particularly considering the fact that so many hospitalized Wuhan Virus patients had pre-existing comorbidity issues, often blood pressure and or cardiac related - so yes, the question becomes what did MRI scans of the heart show before hospitalization for the virus.


12 posted on 02/19/2021 8:35:50 AM PST by Wuli
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To: Red Badger

That’s a very deceptive headline. It’s not 50% of all patients. It’s 50% of the hospitalized patients with an increase in a certain chemical in their blood.


13 posted on 02/19/2021 8:36:19 AM PST by Poser (Cogito ergo Spam - I think, therefore I ham)
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To: Wuli

Sounds like they are looking for some of dat grant money to study further. And further.


14 posted on 02/19/2021 8:37:29 AM PST by crusty old prospector
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To: Red Badger

“Whilst some of it may have been preexistintg”

Duh


15 posted on 02/19/2021 8:39:09 AM PST by wardaddy (P IN 1999 JIM THOMPSON WAS RIGHT ABOUT THE BUSHES ...WE WERE WRONG)
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To: Red Badger
Around 50% of patients who have been hospitalized with severe COVID-19 and who show raised levels of a protein called troponin have damage to their hearts.

So treat them so they don't get a severe case.

16 posted on 02/19/2021 8:39:21 AM PST by metmom (...fixing our eyes on Jesus, the Author and Perfecter of our faith..)
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To: Red Badger

This is B.S.


17 posted on 02/19/2021 8:40:25 AM PST by oil_dude
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To: Red Badger

Wardaddy logic.....who has severe heart disease most of his life and will eventually kill him if a jealous husband doesn’t first....that’s a joke

Perhaps these folks were already varying in levels of cardiac distress and the stress of maybe dying from Covid worsened it

Plus there is elevated troponin and there is etruly elevated troponin

Mild elevation can mean many things ....can even mean acuite emotional stress or lung stress or acute INFECTION

High elevation does mean usually an infarction or pending infarction no question

Covid is hard on heart patients because they are already weak


18 posted on 02/19/2021 8:46:40 AM PST by wardaddy (P IN 1999 JIM THOMPSON WAS RIGHT ABOUT THE BUSHES ...WE WERE WRONG)
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To: crusty old prospector

That is not a question that should be asked. /s


19 posted on 02/19/2021 8:49:28 AM PST by pas
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To: Red Badger

How bad of a case did these patients have? What about patients who only had a very mild case of COVID?


20 posted on 02/19/2021 8:50:37 AM PST by EinNYC
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