Covid-19

Knight, Daniel; Kotecha, Tushar; Razvi, Yousuf; Chacko, Liza; Brown, James; Jeetley, Paramjit; Goldring, James; Jacobs, Michael; Lamb, Lucy; Negus, Rupert; Wolff, Anthony; Moon, James; Xue, Hui; Kellman, Peter; Patel, Niket; Fontana, Marianna

doi:10.1161/circulationaha.120.049252

Cited by 130 publications

(85 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study of previously hospitalised patients, only 26% had a significantly elevated native T 1 . Native T 2 and cardiac function did not differ from our risk-factor matched cohort, consistent with an earlier study [34] . A point worth noting is that differences in prevalence estimates on MRI studies may arise from variations in ‘reference ranges’, methodological differences, and patient characteristics.…”

Section: Discussionsupporting

confidence: 92%

“…[ 2 , 33 ] Cardiac MRI can to be particularly useful in providing a diagnosis in patients with suspected cardiac involvement. [34] In a recent study by Puntmann and colleagues, [35] cardiac MRI showed evidence of a high burden of inflammation (60% of patients), as seen by elevated native T 1 , T 2 and some biventricular impairment in convalescing patients, a third of whom required hospitalisation. In our study of previously hospitalised patients, only 26% had a significantly elevated native T 1 .…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

et al. 2021

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

et al. 2021

View full text Add to dashboard Cite

“…On the other hand, a recent autopsy study shows that the presence of large amounts of the virus in the heart is accompanied by a cytokine response without inflammatory cell infiltration [32]. Cardiac magnetic resonance imaging studies on patients recovered from COVID-19 with cardiac symptoms or unexplained elevated hs-TnT confirm the absence of left ventricular systolic dysfunction and suggest a mixed mechanism showing that cardiac injury in SARS-CoV-2 infection is associated with myocardial edema and then fibrosis [33,34] with a heterogeneous pattern of late gadolinium enhancement including ischemic and non-ischemic patterns as myocarditis-like or non-specific mid-wall late gadolinium enhancement [35].…”

Section: Discussionmentioning

confidence: 84%

Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study

Lairez

Blanchard

Houard

et al. 2020

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Biological cardiac injury related to the Severe Acute Respiratory Syndrome Coronavirus-2 infection has been associated with excess mortality. However, its functional impact remains unknown. The aim of our study was to explore the impact of biological cardiac injury on myocardial functions in patients with COVID-19. 31 patients with confirmed COVID-19 (CoV+) and 16 controls (CoV−) were prospectively included in this observational study. Demographic data, laboratory findings, comorbidities, treatments and myocardial function assessed by transthoracic echocardiography were collected and analysed in CoV+ with (TnT+) and without (TnT−) elevation of troponin T levels and compared with CoV−. Among CoV+, 13 (42%) exhibited myocardial injury. CoV+/TnT + patients were older, had lower diastolic arterial pressure and were more likely to have hypertension and chronic renal failure compared with CoV+/TnT−. The control group was comparable except for an absence of biological inflammatory syndrome. Left ventricular ejection fraction and global longitudinal strain were not different among the three groups. There was a trend of decreased myocardial work and increased peak systolic tricuspid annular velocity between the CoV− and CoV + patients, which became significant when comparing CoV− and CoV+/TnT+ (2167 ± 359 vs. 1774 ± 521%/mmHg, P = 0.047 and 14 ± 3 vs. 16 ± 3 cm/s, P = 0.037, respectively). There was a decrease of global work efficiency from CoV− (96 ± 2%) to CoV+/TnT− (94 ± 4%) and then CoV+/TnT+ (93 ± 3%, P = 0.042). In conclusion, biological myocardial injury in COVID 19 has low functional impact on left ventricular systolic function. Keywords COVID-19 • SARS-CoV-2 • Speckle tracking echocardiography • Strain • Myocardial work. Abbreviations CT Computed tomography hs-TnT High-sensitivity troponin T IQR Interquartile ranges LS Longitudinal strain TTE Transthoracic echocardiography RT-PCR Real-time reverse transcriptase-polymerase chain reaction SARS-CoV-2 Severe acute respiratory syndrome coronavirus-2 TAPSE Tricuspid annular plane systolic excursion

show abstract

“…This premise is further supported by the fact that autopsy studies have not shown widespread direct myocarditis from COVID-19. 36 MRI reports suggest abnormal myocardial signal in many patients with COVID-19, 37 – 40 but patients with myocardial injury attributable to sepsis also manifest significant and common abnormalities on cardiac MRI. 41 In our study, patients with COVID-19 with myocardial injury had worse prognosis than patients with pneumonia ARDS with myocardial injury; whether this incremental adverse prognosis is related to baseline comorbidities or to differing pathogenesis of myocardial injury such as thrombotic complications 36 needs to be clarified.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Injury in Severe COVID-19 Compared With Non–COVID-19 Acute Respiratory Distress Syndrome

et al. 2021

View full text Add to dashboard Cite

Background: Knowledge gaps remain in the epidemiology and clinical implications of myocardial injury in COVID-19. Our goal was to determine the prevalence and outcomes of myocardial injury in severe COVID-19 compared to acute respiratory distress syndrome (ARDS) unrelated to COVID-19. Methods: We included intubated COVID-19 patients from 5 hospitals between March 15 and June 11, 2020 with troponin levels assessed. We compared them to patients from a cohort study of myocardial injury in ARDS. We performed survival analysis with primary outcome of in-hospital death associated with myocardial injury. We performed linear regression to identify clinical factors associated with myocardial injury in COVID-19. Results: Of 243 patients intubated with COVID-19, 51% had troponin levels > upper limit of normal (ULN). Chronic kidney disease, lactate, ferritin and fibrinogen were associated with myocardial injury. Mortality was 22.7% among COVID-19 patients with troponin < ULN and 61.5% for those with troponin levels > 10xULN (P< 0.001). The association of myocardial injury with mortality was not statistically significant after adjusting for age, sex and multi-system organ dysfunction. Compared to non-COVID ARDS patients, patients with COVID-19 were older with higher creatinine and less favorable vital signs. After adjustment, COVID-19 was associated with lower odds of myocardial injury compared to non-COVID ARDS (OR 0.55 95% CI 0.36-0.84, P=0.005). Conclusions: Myocardial injury in severe COVID-19 is a function of baseline comorbidities, advanced age and multisystem organ dysfunction similar to traditional ARDS. The adverse prognosis of myocardial injury in COVID-19 relates largely to multisystem organ involvement and critical illness.

show abstract

Covid-19

Cited by 130 publications

References 6 publications

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study

Myocardial Injury in Severe COVID-19 Compared With Non–COVID-19 Acute Respiratory Distress Syndrome

Contact Info

Product

Resources

About