Myocardial Injury as a Prognostic Factor in Mid- and Long-Term Follow-Up of COVID-19 Survivors

Izquierdo, Andrea; Mojón, Diana; Bardajı́, Alfredo; Carrasquer, Anna; Calvo-Fernández, Alicia; Carreras-Mora, José; Giralt, Teresa; Pérez, Sonia González; Farré, Núria; Soler, Cristina; Solà-Richarte, Claudia; Cabero, Paula; Vaquerizo, Beatriz; Marrugat, Jaume; Ribas, Núria

doi:10.3390/jcm10245900

Cited by 14 publications

(11 citation statements)

References 43 publications

(66 reference statements)

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“…To date, only few studies regarding the cardiovascular longterm consequences after recovery fromCOVID-19 have been published (Supplementary Table 1), suggesting worse long-term outcomes (69)(70)(71)(72). In our previous published study of a cohort with 172 patients who survived COVID-19 hospitalization, myocardial injury was associated with poor prognosis, mainly due to a higher number of readmissions (71). In the same direction, Kini et al (70) found that the risk of death at 30 days was significantly increased in those patients who had myocardial injury during the acute phase.…”

Section: Prognostic Implications Of Myocardial Damage In Covid-19 Pat...mentioning

confidence: 99%

Myocardial Injury in COVID-19 and Its Implications in Short- and Long-Term Outcomes

Izquierdo-Marquisá

Cubero-Gallego

Alonso

et al. 2022

Front. Cardiovasc. Med.

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COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still a pandemic with high mortality and morbidity rates. Clinical manifestation is widely variable, including asymptomatic or mild respiratory tract illness to severe pneumonia and death. Myocardial injury is a significant pathogenic feature of COVID-19 and it is associated with worse in-hospital outcomes, mainly due to a higher number of hospital readmissions, with over 50% mortality. These findings suggest that myocardial injury would identify COVID-19 patients with higher risk during active infection and mid-term follow-up. Potential contributors responsible for myocardial damage are myocarditis, vasculitis, acute inflammation, type 1 and type 2 myocardial infarction. However, there are few data about cardiac sequelae and its long-term consequences. Thus, the optimal screening tool for residual cardiac sequelae, clinical follow-up, and the benefits of a specific cardiovascular therapy during the convalescent phase remains unknown. This mini-review explores the different mechanisms of myocardial injury related to COVID-19 and its short and long-term implications.

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Section: Prognostic Implications Of Myocardial Damage In Covid-19 Pat...mentioning

confidence: 99%

Myocardial Injury in COVID-19 and Its Implications in Short- and Long-Term Outcomes

Izquierdo-Marquisá

Cubero-Gallego

Alonso

et al. 2022

Front. Cardiovasc. Med.

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“…[4][5][6][7][8] In our previous study on this topic, we found an incidence of aPH, based on echocardiographic criteria, of 39% in Covid-19 patients admitted to intensive care (ICU) and that early mortality (21 days) was increased more than 6-fold compared to patients without signs of aPH. 4 In previous follow-up reports on hospitalized Covid-19 patients, 9,10 the issue of aPH has not been reported in any detail.…”

Section: Introductionmentioning

confidence: 99%

“…In previous follow‐up reports on hospitalized Covid‐19 patients, 9,10 the issue of aPH has not been reported in any detail. Against the results of our previous study, we hypothesized that mortality may continue to be elevated after 1 month in patients with Covid‐19 and aPH.…”

Section: Introductionmentioning

confidence: 99%

Severe Covid‐19 and acute pulmonary hypertension: 24‐month follow‐up regarding mortality and relationship to initial echocardiographic findings and biomarkers

Norderfeldt

Liliequist

Eksborg

et al. 2022

Acta Anaesthesiol Scand

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Introduction Critically ill Covid‐19 patients are likely to develop the sequence of acute pulmonary hypertension (aPH), right ventricular strain, and eventually right ventricular failure due to currently known pathophysiology (endothelial inflammation plus thrombo‐embolism) that promotes increased pulmonary vascular resistance and pulmonary artery pressure. Furthermore, an in‐hospital trans‐thoracic echocardiography (TTE) diagnosis of aPH is associated with a substantially increased risk of early mortality. The aim of this retrospective observational follow‐up study was to explore the mortality during the 1–24‐month period following the TTE diagnosis of aPH in the intensive care unit (ICU). Methods A previously reported cohort of 67 ICU‐treated Covid‐19 patients underwent an electronic medical chart‐based follow‐up 24 months after the ICU TTE. Apart from the influence of aPH versus non‐aPH on mortality, several TTE parameters were analyzed by the Kaplan–Meier survival plot technique (K‐M). The influence of biomarkers for heart failure (NTproBNP) and myocardial injury (Troponin‐T), taken at the time of the ICU TTE investigation, was analyzed using receiver‐operator characteristics curve (ROC) analysis. Results The overall mortality at the 24‐month follow‐up was 61.5% and 12.8% in group aPH and group non‐aPH, respectively. An increased relative mortality risk continued to be present in aPH patients (14.3%) compared to non‐aPH patients (5.6%) during the 1–24‐month period. The easily determined parameter of a tricuspid valve regurgitation, allowing a measurement of a systolic pulmonary artery pressure (regardless of magnitude), was associated with a similar K‐M outcome as the generally accepted diagnostic criteria for aPH (systolic pulmonary artery pressure >35 mmHg). The biomarker values of NTproBNP and Troponin‐T at the time of the TTE did not result in any clinically useful ROC analysis data. Conclusion The mortality risk was increased up to 24 months after the initial examination in ICU‐treated Covid‐19 patients with a TTE diagnosis of aPH, compared to non‐aPH patients. Certain individual TTE parameters were able to discriminate 24‐month risk of morality.

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“…There is little information on the long-term consequences of COVID-19 in patients after hospital discharge. Most studies have been limited to hospitalized individuals, and all had a short duration of follow-up and narrow selection of cardiovascular outcomes (12)(13)(14). Recently, a large study showed that, beyond the first 30 days of infection, people with COVID-19 exhibited increased risk for and 12-month burden of cardiovascular diseases (15).…”

Section: Introductionmentioning

confidence: 99%

The natural history of QTc interval and its clinical impact in coronavirus disease 2019 survivors after 1 year

Mojón-Álvarez

Izquierdo

Cubero-Gallego

et al. 2023

Front. Cardiovasc. Med.

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Background and objectiveProlonged QTc interval on admission and a higher risk of death in SARS-CoV-2 patients have been reported. The long-term clinical impact of prolonged QTc interval is unknown. This study examined the relationship in COVID-19 survivors of a prolonged QTc on admission with long-term adverse events, changes in QTc duration and its impact on 1-year prognosis, and factors associated with a prolonged QTc at follow-up.MethodsWe conducted a single-center prospective cohort study of 523 SARS-CoV-2-positive patients who were alive on discharge. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval and repeated in 421 patients 7 months after discharge. Mortality, hospital readmission, and new arrhythmia rates 1 year after discharge were reviewed.ResultsThirty-one (6.3%) survivors had a baseline prolonged QTc. They were older, had more cardiovascular risk factors, cardiac disease, and comorbidities, and higher levels of terminal pro-brain natriuretic peptide. There was no relationship between prolonged QTc on admission and the 1-year endpoint (9.8% vs. 5.5%, p = 0.212). In 84% of survivors with prolonged baseline QTc, it normalized at 7.9 ± 2.2 months. Of the survivors, 2.4% had prolonged QTc at follow-up, and this was independently associated with obesity, ischemic cardiomyopathy, chronic obstructive pulmonary disease, and cancer. Prolonged baseline QTc was not independently associated with the composite adverse event at 1 year.ConclusionsProlonged QTc in the acute phase normalized in most COVID-19 survivors and had no clinical long-term impact. Prolonged QTc at follow-up was related to the presence of obesity and previously acquired chronic diseases and was not related to 1-year prognosis.

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Myocardial Injury as a Prognostic Factor in Mid- and Long-Term Follow-Up of COVID-19 Survivors

Cited by 14 publications

References 43 publications

Myocardial Injury in COVID-19 and Its Implications in Short- and Long-Term Outcomes

Myocardial Injury in COVID-19 and Its Implications in Short- and Long-Term Outcomes

Severe Covid‐19 and acute pulmonary hypertension: 24‐month follow‐up regarding mortality and relationship to initial echocardiographic findings and biomarkers

The natural history of QTc interval and its clinical impact in coronavirus disease 2019 survivors after 1 year

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