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Long-term cardiac pathology in individuals with mild initial COVID-19 illness
Cardiac symptoms are increasingly recognized as late complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in previously well individuals with mild initial illness, but the underlying pathophysiology leading to long-term cardiac symptoms remains unclear. In this stu...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556300/ https://www.ncbi.nlm.nih.gov/pubmed/36064600 http://dx.doi.org/10.1038/s41591-022-02000-0 |
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author | Puntmann, Valentina O. Martin, Simon Shchendrygina, Anastasia Hoffmann, Jedrzej Ka, Mame Madjiguène Giokoglu, Eleni Vanchin, Byambasuren Holm, Niels Karyou, Argyro Laux, Gerald S. Arendt, Christophe De Leuw, Philipp Zacharowski, Kai Khodamoradi, Yascha Vehreschild, Maria J. G. T. Rohde, Gernot Zeiher, Andreas M. Vogl, Thomas J. Schwenke, Carsten Nagel, Eike |
author_facet | Puntmann, Valentina O. Martin, Simon Shchendrygina, Anastasia Hoffmann, Jedrzej Ka, Mame Madjiguène Giokoglu, Eleni Vanchin, Byambasuren Holm, Niels Karyou, Argyro Laux, Gerald S. Arendt, Christophe De Leuw, Philipp Zacharowski, Kai Khodamoradi, Yascha Vehreschild, Maria J. G. T. Rohde, Gernot Zeiher, Andreas M. Vogl, Thomas J. Schwenke, Carsten Nagel, Eike |
author_sort | Puntmann, Valentina O. |
collection | PubMed |
description | Cardiac symptoms are increasingly recognized as late complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in previously well individuals with mild initial illness, but the underlying pathophysiology leading to long-term cardiac symptoms remains unclear. In this study, we conducted serial cardiac assessments in a selected population of individuals with Coronavirus Disease 2019 (COVID-19) with no previous cardiac disease or notable comorbidities by measuring blood biomarkers of heart injury or dysfunction and by performing magnetic resonance imaging. Baseline measurements from 346 individuals with COVID-19 (52% females) were obtained at a median of 109 days (interquartile range (IQR), 77–177 days) after infection, when 73% of participants reported cardiac symptoms, such as exertional dyspnea (62%), palpitations (28%), atypical chest pain (27%) and syncope (3%). Symptomatic individuals had higher heart rates and higher imaging values or contrast agent accumulation, denoting inflammatory cardiac involvement, compared to asymptomatic individuals. Structural heart disease or high levels of biomarkers of cardiac injury or dysfunction were rare in symptomatic individuals. At follow-up (329 days (IQR, 274–383 days) after infection), 57% of participants had persistent cardiac symptoms. Diffuse myocardial edema was more pronounced in participants who remained symptomatic at follow-up as compared to those who improved. Female gender and diffuse myocardial involvement on baseline imaging independently predicted the presence of cardiac symptoms at follow-up. Ongoing inflammatory cardiac involvement may, at least in part, explain the lingering cardiac symptoms in previously well individuals with mild initial COVID-19 illness. |
format | Online Article Text |
id | pubmed-9556300 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group US |
record_format | MEDLINE/PubMed |
spelling | pubmed-95563002022-10-14 Long-term cardiac pathology in individuals with mild initial COVID-19 illness Puntmann, Valentina O. Martin, Simon Shchendrygina, Anastasia Hoffmann, Jedrzej Ka, Mame Madjiguène Giokoglu, Eleni Vanchin, Byambasuren Holm, Niels Karyou, Argyro Laux, Gerald S. Arendt, Christophe De Leuw, Philipp Zacharowski, Kai Khodamoradi, Yascha Vehreschild, Maria J. G. T. Rohde, Gernot Zeiher, Andreas M. Vogl, Thomas J. Schwenke, Carsten Nagel, Eike Nat Med Article Cardiac symptoms are increasingly recognized as late complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in previously well individuals with mild initial illness, but the underlying pathophysiology leading to long-term cardiac symptoms remains unclear. In this study, we conducted serial cardiac assessments in a selected population of individuals with Coronavirus Disease 2019 (COVID-19) with no previous cardiac disease or notable comorbidities by measuring blood biomarkers of heart injury or dysfunction and by performing magnetic resonance imaging. Baseline measurements from 346 individuals with COVID-19 (52% females) were obtained at a median of 109 days (interquartile range (IQR), 77–177 days) after infection, when 73% of participants reported cardiac symptoms, such as exertional dyspnea (62%), palpitations (28%), atypical chest pain (27%) and syncope (3%). Symptomatic individuals had higher heart rates and higher imaging values or contrast agent accumulation, denoting inflammatory cardiac involvement, compared to asymptomatic individuals. Structural heart disease or high levels of biomarkers of cardiac injury or dysfunction were rare in symptomatic individuals. At follow-up (329 days (IQR, 274–383 days) after infection), 57% of participants had persistent cardiac symptoms. Diffuse myocardial edema was more pronounced in participants who remained symptomatic at follow-up as compared to those who improved. Female gender and diffuse myocardial involvement on baseline imaging independently predicted the presence of cardiac symptoms at follow-up. Ongoing inflammatory cardiac involvement may, at least in part, explain the lingering cardiac symptoms in previously well individuals with mild initial COVID-19 illness. Nature Publishing Group US 2022-09-05 2022 /pmc/articles/PMC9556300/ /pubmed/36064600 http://dx.doi.org/10.1038/s41591-022-02000-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Puntmann, Valentina O. Martin, Simon Shchendrygina, Anastasia Hoffmann, Jedrzej Ka, Mame Madjiguène Giokoglu, Eleni Vanchin, Byambasuren Holm, Niels Karyou, Argyro Laux, Gerald S. Arendt, Christophe De Leuw, Philipp Zacharowski, Kai Khodamoradi, Yascha Vehreschild, Maria J. G. T. Rohde, Gernot Zeiher, Andreas M. Vogl, Thomas J. Schwenke, Carsten Nagel, Eike Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title | Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title_full | Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title_fullStr | Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title_full_unstemmed | Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title_short | Long-term cardiac pathology in individuals with mild initial COVID-19 illness |
title_sort | long-term cardiac pathology in individuals with mild initial covid-19 illness |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556300/ https://www.ncbi.nlm.nih.gov/pubmed/36064600 http://dx.doi.org/10.1038/s41591-022-02000-0 |
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