tetano
Editor, Senior Moderator
Am Heart J
. 2021 Aug 13;S0002-8703(21)00197-6.
doi: 10.1016/j.ahj.2021.08.001. Online ahead of print.
Cardiac Pathology 6 Months after Hospitalization for COVID-19 and Association with the Acute Disease Severity: Cardiac MRI 6 months after COVID-19
Peder L Myhre[SUP] 1 [/SUP], Siri L Heck[SUP] 2 [/SUP], Julia B Skranes[SUP] 1 [/SUP], Christian Prebensen[SUP] 3 [/SUP], Christine M Jonassen[SUP] 4 [/SUP], Trygve Berge[SUP] 5 [/SUP], Albulena Mecinaj[SUP] 1 [/SUP], Woldegabriel Melles[SUP] 6 [/SUP], Gunnar Einvik[SUP] 7 [/SUP], Charlotte B Ingul[SUP] 8 [/SUP], Arnljot Tveit[SUP] 5 [/SUP], Jan Erik Berdal[SUP] 3 [/SUP], Helge Røsjø[SUP] 9 [/SUP], Magnus N Lyngbakken[SUP] 1 [/SUP], Torbjørn Omland[SUP] 10 [/SUP]
Affiliations
Abstract
Background: 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 three 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 versus without abnormal CMR after 6 months. SARS-CoV-2 viremia and concentrations of inflammatory biomarkers 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.
Keywords: C-reactive protein, CRP; COVID-19, cardiac magnetic resonance imaging, CMR, biomarkers, troponin, NT-proBNP, ABBREVIATION LIST; Cardiac troponin T, cTnT; Coronavirus disease 2019, COVID-19; Estimated glomerular filtration rate, eGFR; Intensive care unit, ICU; Interleukin-6, IL-6; Late Gadolinium Enhancement, LGE; N-terminal pro-B-type natriuretic peptide, NT-proBNP; National Early Warning Score, NEWS; Procalcitonin, PCT; Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2.
. 2021 Aug 13;S0002-8703(21)00197-6.
doi: 10.1016/j.ahj.2021.08.001. Online ahead of print.
Cardiac Pathology 6 Months after Hospitalization for COVID-19 and Association with the Acute Disease Severity: Cardiac MRI 6 months after COVID-19
Peder L Myhre[SUP] 1 [/SUP], Siri L Heck[SUP] 2 [/SUP], Julia B Skranes[SUP] 1 [/SUP], Christian Prebensen[SUP] 3 [/SUP], Christine M Jonassen[SUP] 4 [/SUP], Trygve Berge[SUP] 5 [/SUP], Albulena Mecinaj[SUP] 1 [/SUP], Woldegabriel Melles[SUP] 6 [/SUP], Gunnar Einvik[SUP] 7 [/SUP], Charlotte B Ingul[SUP] 8 [/SUP], Arnljot Tveit[SUP] 5 [/SUP], Jan Erik Berdal[SUP] 3 [/SUP], Helge Røsjø[SUP] 9 [/SUP], Magnus N Lyngbakken[SUP] 1 [/SUP], Torbjørn Omland[SUP] 10 [/SUP]
Affiliations
- PMID: 34400140
- DOI: 10.1016/j.ahj.2021.08.001
Abstract
Background: 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 three 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 versus without abnormal CMR after 6 months. SARS-CoV-2 viremia and concentrations of inflammatory biomarkers 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.
Keywords: C-reactive protein, CRP; COVID-19, cardiac magnetic resonance imaging, CMR, biomarkers, troponin, NT-proBNP, ABBREVIATION LIST; Cardiac troponin T, cTnT; Coronavirus disease 2019, COVID-19; Estimated glomerular filtration rate, eGFR; Intensive care unit, ICU; Interleukin-6, IL-6; Late Gadolinium Enhancement, LGE; N-terminal pro-B-type natriuretic peptide, NT-proBNP; National Early Warning Score, NEWS; Procalcitonin, PCT; Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2.