Heart Abnormalities Found in Recovered Patients Suggest COVID-19 Significantly Impacts Cardiovascular System

In the observational cohort study, the researchers identified 100 unselected coronavirus patients, 57 risk factor-matched patients, and 50 healthy volunteers from the University Hospital Frankfurt’s COVID-19 Registry. The team performed cardiac magnetic resonance (CMR) imaging which showed heart involvement in 78 patients and active cardiac inflammation in 60 patients, irrespective of their underlying conditions, disease severity, course of illness, and time from diagnosis to CMR.

Out of 100 patients, 33 required hospitalization and 71 COVID-19 patients had detectable levels of high-sensitivity troponin, while five patients showed significantly high levels. The patients who had recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, higher left ventricle mass, and elevated native T1 and T2 than controls, all of which indicated heart dysfunction. Additionally, abnormal CMR findings were observed in 78 coronavirus patients, including 73 with higher myocardial native T1, 60 with higher myocardial native T2, 32 with myocardial late gadolinium enhancement, and 22 with pericardial enhancement, all of which are signs of heart damage. In patients with serious findings, a biopsy of the heart muscle revealed ongoing immune-mediated inflammation.

The various types of heart abnormalities revealed by CMR in the study, each of which is related to underlying dysfunction and worse outcomes, offers strong evidence that COVID-19 has a significant impact on the cardiovascular system by worsening heart failure in patients with preexisting cardiac diseases. The findings are significant as a majority of the coronavirus research has focused on short-term respiratory complications, particularly in critically ill patients.

"While left and right ventricular ejection fraction were significantly reduced, there was a large overlap between patients recently recovered from COVID-19 and both control groups, demonstrating that volumes and function are inferior markers of disease detection," wrote the researchers.