Published 09:07 IST, February 22nd 2021
COVID-19 recovered patients prone to cardiac damage due to rise in troponin levels: Study
COVID-19 survivors may endure long-term damage to heart, particularly after intensive care admission, a research published in European Heart Journal revealed.
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) leads to an increase in troponin in almost 50 percent of patients, which can be used as a marker of disease severity and predicts future cardiovascular events, a new study found. Published in the US National Institute of Health and the European Heart Journal, the research found that the recovered patients of COVID-19 were more prone to getting myocardial injury due to troponin elevation.
Scientists took one hundred and forty-eight recovered covid positive patients’ samples and used multi-parametric cardiovascular magnetic resonance (CMR) to assess myocardial injury in the hearts. “During convalescence after severe COVID-19 infection with troponin elevation, myocarditis-like injury can be encountered, with the limited extent and minimal functional consequence,” the study said. There is also increasing evidence of possible ongoing localized inflammation, and survivors may endure long-term damage to the heart, particularly after intensive care admission, according to the researchers.
[Consort diagram. CMR, cardiovascular magnetic resonance. Credit: European Heart Journal]
"During severe Covid-19 infection, 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," Professor Marianna Fontana, professor of cardiology at University College London (UK), who led the research said.
Troponin levels linked to mortality
An acute respiratory infection such as COVID-19 is associated with elevated serum troponin levels, which is linked with mortality even after recovery. The elevated troponin, which is found common in the hospitalized COVID-19 patients, can have adverse outcomes long after the person recovered from coronavirus infection, according to scientists. “A variety of mechanisms responsible for troponin rise have been proposed including acute coronary syndromes, unmasking occult underlying cardiovascular disease, arrhythmias, myocarditis, or as part of a systemic inflammatory syndrome,” the research indicated. The multicentric study was conducted across six acute hospitals, which ran 4 scanners on patients to assess the presence, type, and extent of myocardial injury using quality-controlled CMR. It was found that the patients surviving COVID-19 hospital admission had elevated serum troponin levels, which are released into the blood due to heart muscle injury.
[Example of patient with a myocarditis-pattern. Credit: European Heart Journal]
Dr. Graham Cole, a consultant cardiologist at Imperial College London, said: "Raised troponin levels are associated with worse outcomes in Covid-19 patients.”
Updated 09:07 IST, February 22nd 2021