Coronavirus Disease 2019 (COVID-19) and the Heart—Is Heart Failure the Next Chapter? (JAMA, 27 July)

https://jamanetwork.com/journals/jama...

https://jamanetwork.com/journals/jama...

Increased risk for morbid and mortal complications in COVID

Pre existing cardiovascular diseases

Hypertension

Coronary artery disease

Heart failure

COVID causing heart disease

39 autopsy cases, died from COVID-19 pneumonia

Histopathologic evaluation did not meet criteria seen in acute myocarditis

Evidence of virus present in the heart in 24 of 39 patients (61.5%)

Of these 24, 16 (66.7%) patients had a high viral load

Evidence of active viral replication was also noted

Also increased activation of pro-inflammatory genes in the heart

Myocardial injury therefore possible by 2 mechanisms

In 100 recovering patients

Evaluated a mean of 71 days after confirmed COVID-19 diagnosis

Detectable troponin

Reduced left ventricular ejection fraction

Ischaemia

Pericardial involvement

Cardiomyopathy and heart failure related to COVID-19 may become evident

Potential ongoing morbidity of heart failure and other chronic cardiovascular complications

British heart foundation
https://www.bhf.org.uk/informationsup...