Article ; Online: Cardiac pathology 6 months after hospitalization for COVID-19 and association with the acute disease severity.
2021 Volume 242, Page(s) 61–70
Abstract: ... Conclusions: CMR pathology 6 months after moderate-to-severe COVID-19 was present in 21% of patients and did ... in patients recovered from moderate-to-severe COVID-19, and its association with markers of disease severity ... reports of persistent cardiac pathology after COVID-19 have raised concerns of long-term cardiac ...
| Abstract | Background: Coronavirus disease 2019 (COVID-19) may cause myocardial injury and myocarditis, and reports of persistent cardiac pathology after COVID-19 have raised concerns of long-term cardiac consequences. We aimed to assess the presence of abnormal cardiovascular resonance imaging (CMR) findings in patients recovered from moderate-to-severe COVID-19, and its association with markers of disease severity in the acute phase. Methods: Fifty-eight (49%) survivors from the prospective COVID MECH study, underwent CMR median 175 [IQR 105-217] days after COVID-19 hospitalization. Abnormal CMR was defined as left ventricular ejection fraction (LVEF) <50% or myocardial scar by late gadolinium enhancement. CMR indices were compared to healthy controls (n = 32), and to circulating biomarkers measured during the index hospitalization. Results: Abnormal CMR was present in 12 (21%) patients, of whom 3 were classified with major pathology (scar and LVEF <50% or LVEF <40%). There was no difference in the need of mechanical ventilation, length of hospital stay, and vital signs between patients with vs without abnormal CMR after 6 months. Severe acute respiratory syndrome coronavirus 2 viremia and concentrations of inflammatory biomarkers during the index hospitalization were not associated with persistent CMR pathology. Cardiac troponin T and N-terminal pro-B-type natriuretic peptide concentrations on admission, were higher in patients with CMR pathology, but these associations were not significant after adjusting for demographics and established cardiovascular disease. Conclusions: CMR pathology 6 months after moderate-to-severe COVID-19 was present in 21% of patients and did not correlate with severity of the disease. Cardiovascular biomarkers during COVID-19 were higher in patients with CMR pathology, but with no significant association after adjusting for confounders. Trial registration: COVID MECH Study ClinicalTrials.gov Identifier: NCT04314232. |
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| MeSH term(s) | Adult ; Aged ; Biomarkers/blood ; COVID-19/blood ; COVID-19/complications ; Cicatrix/diagnostic imaging ; Cicatrix/etiology ; Female ; Gadolinium ; Heart Diseases/blood ; Heart Diseases/diagnostic imaging ; Heart Diseases/etiology ; Heart Diseases/physiopathology ; Humans ; Magnetic Resonance Imaging, Cine/methods ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Peptide Fragments/blood ; Prospective Studies ; Severity of Illness Index ; Stroke Volume ; Survivors ; Troponin T/blood ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology | |||||
| Chemical Substances | Biomarkers ; Peptide Fragments ; Troponin T ; pro-brain natriuretic peptide (1-76) ; Natriuretic Peptide, Brain (114471-18-0) ; Gadolinium (AU0V1LM3JT) | |||||
| Language | English | |||||
| Publishing date | 2021-08-13 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 80026-0 | |||||
| ISSN | 1097-6744 ; 0002-8703 | |||||
| ISSN (online) | 1097-6744 | |||||
| ISSN | 0002-8703 | |||||
| DOI | 10.1016/j.ahj.2021.08.001 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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