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Heart abnormalities revealed in COVID-19 patients

Monday July 13th 2020

Half of COVID-19 patients who had a heart scan in hospital were diagnosed with abnormalities in their heart function, a study reveals today.

New research, published in Cardiovascular Imaging, found about one in seven patients had severe abnormalities that were likely to have a major effect on their survival and recovery, while one in three had their treatment changed as a result an echocardiography scan.

The findings of the study, funded by British Heart Foundation, suggest that heart scans could be crucial for identifying patients who could benefit from additional treatments to help their recovery from the coronavirus and prevent potential long-term damage to their heart.

Researchers from the British Heart Foundation Centre of Research Excellence at the University of Edinburgh examined echocardiogram results of 1216 COVID-19 patients from 69 countries and found 55% of all patients, including those with existing heart disease, experienced abnormal changes to the way their heart was pumping, with about one in seven showing evidence of severe dysfunction.

Most of the patients – 901 – had no known heart disease before the study but also showed similar changes, while 46% showed abnormal changes and 13% severe dysfunction. Because these changes were seen for the first time when the patients had COVID-19, researchers believe they are effects of the virus.

The researchers highlight some limitations with their observational study, including that the number of scans being carried out would have been carefully balanced with the risk of exposing staff, patients and equipment to the virus.

Patients who received the scans were in hospital and had suspected heart complications, usually because they had abnormal blood markers reflecting heart damage.

Professor Marc Dweck, British Heart Foundation senior lecturer and consultant cardiologist at the University of Edinburgh, said: “COVID-19 is a complex, multisystem disease which can have profound effects on many parts of the body, including the heart.

“Many doctors have been hesitant to order echocardiograms for patients with COVID-19 because it’s an added procedure which involves close contact with patients. Our work shows that these scans are important – they improved the treatment for a third of patients who received them.

“Damage to the heart is known to occur in severe flu, but we were surprised to see so many patients with damage to their heart with COVID-19 and so many patients with severe dysfunction. We now need to understand the exact mechanism of this damage, whether it is reversible and what the long-term consequences of COVID-19 infection are on the heart.”

Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, added: “This global study – carried out at the height of the pandemic – shows that we must be on the lookout for heart complications in people with COVID-19 so that we can adapt their treatment, if needed.”

* A report in Stroke says acute ischaemic strokes associated with the virus have been more severe and have had worse outcomes and higher mortality than usual.

The findings come from a study of 174 patients treated at 28 centres in 16 countries.

Cardiovascular Imaging 13 July 2020

Stroke 10 July 2020; doi: 10.1161/STROKEAHA.120.031208

Tags: Flu & Viruses | Heart Health | UK News

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