Myocardial Involvement After Hospitalization for COVID-19 Complicated by Troponin Elevation: A Prospective,...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• Acute myocardial injury in COVID-19 patients is linked to poor outcomes.
• The exact causes and associations of this injury remain unclear.
• This study investigates myocardial damage in hospitalized COVID-19 patients with elevated troponin.

Purpose of the Study:

• To assess the presence, nature, and extent of myocardial damage.
• To identify predictors of major adverse cardiovascular events in COVID-19 patients.

Main Methods:

• 342 COVID-19 patients with elevated troponin (COVID+/troponin+) underwent MRI.
• Two control groups were used: COVID-19 with normal troponin (COVID+/troponin-) and non-COVID-19 with comorbidities (COVID-/comorbidity+).
• Regression modeling identified predictors of 12-month major adverse cardiovascular events.

Main Results:

• COVID+/troponin+ patients had significantly higher rates of heart abnormalities (61%) versus controls (36% and 31%).
• Ventricular impairment and myocardial scar were more prevalent in COVID+/troponin+ patients.
• Myocardial scar, not prior COVID-19 or troponin levels, independently predicted major adverse cardiovascular events (OR 2.25).

Conclusions:

• COVID-19 patients with elevated troponin exhibit increased ventricular impairment and myocardial scar.
• The study identified a diverse scar pathogenesis, including microinfarction.
• Myocardial scar is a significant predictor of future cardiovascular events in these patients.