COVID-19 patients may develop long-term cardiovascular complications, according to a new study from Germany that used cardiac magnetic resonance (CMR) imaging.
Valentin O. Puntmann, MD, PhD, of University Hospital Frankfurt, and colleagues reported these results in a manuscript published online Monday in JAMA Cardiology.
As the COVID-19 pandemic continues, more data accumulate on its impact on morbidity and mortality around the world, with the pronounced cardiovascular effects. A number of underlying causes of myocardial injury have been proposed, from inflammatory plaque rupture to the angiotensin-converting enzyme 2 receptors causing systemic endothelitis.
A total of 100 patients who recovered from COVID-19 were examined by CMR to determine their extent of cardiac injury. The group included some patients with pre-existing conditions such as hypertension and diabetes. The patients ranged from non-symptomatic to severe, including those requiring mechanical ventilation. Some patients received treatment with antivirals, antibiotics and steroids. The examination was performed between 64 and 92 days from the time the patient was determined positive for COVID-19 by reverse transcription-polymerase chain reaction on swab test of the upper respiratory tract.
CMR showed that 78% of the patients had cardiac involvement. This involvement was not related to any pre-existing conditions, the presence of cardiac symptoms during the course of the infection or to the severity of the infection. Myocardial inflammation was the most prevalent finding in 60% of the patients, followed by regional scar and pericardial enhancement.
The authors conclude that their findings may implicate COVID 19 in the pathophysiology of inflammatory cardiac disease. More studies on the long-term effects of COVID 19 infections need to be undertaken in the general population.
Puntmann VO, Carerj ML, Wieters I, et al Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol 2020 Jul 27. doi:10.1001/jamacardio.2020.3557