Mechanisms of Myocardial Injury in Coronavirus Disease 2019

Rali, Aniket S; Ranka, Sagar; Shah, Zubair; Sauer, Andrew J.

doi:10.15420/cfr.2020.10

Cited by 28 publications

(27 citation statements)

References 59 publications

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“…The persistence of visual LGE at 3-month follow-up re ecting necrosis (persistent in ammation) or scar ( brosis) might be caused by COVID-19 and needs to be elucidated further 21 . Yet, visual LGE indicated that up to 30% COVID-19 patients have irreversible myocardial injury 22,23 , which is consistent with the ndings of the previous study and can con rm one of the main mechanisms of COVID-19 induced direct myocardial injury-myocarditis [24][25][26] . In addition, the presence of LGE has been proven to be an independent predictor of all-cause mortality and cardiac mortality in myocarditis 27,28 .…”

Section: Discussionsupporting

confidence: 91%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiac magnetic resonance imaging (CMRI). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMRIMethods: A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMRI examination in this study. The CMRI protocol consisted of black blood fat-suppressed T2 weighted imaging (BB-T2WI), T2 star mapping, left ventricle cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). Myocardium edema and LGE were assessed in recovered COVID-19 patients. The left ventricle (LV) and right ventricle (RV) function and LV mass were assessed and compared with normal controls.Results: Finally, 44 recovered COVID-19 patients and 31 normal controls were included in this study. No edema was observed in any patient. LGE was found in 13 patients. All LGE lesions were located in the middle myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased left ventricle peak global circumferential strain (LVpGCS), right ventricle peak global circumferential strain (RVpGCS), right ventricle peak global longitudinal strain (RVpGLS) as compared to non-LGE patients (p＜0.05), while no difference was detected between the non-LGE patients and normal controls.Conclusion: Myocardium injury existed in about 30% of COVID-19 patients. These patients had peak right ventricle strain that decreased at the 3-month follow-up. Cardiac MRI can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of left ventricle circumferential contraction dysfunction and right ventricular dysfunction.

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Section: Discussionsupporting

confidence: 91%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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“…7 In one of the first manuscripts on COVID-19 and cardiovascular effects, specifically myocardial injury, Rali et al elegantly elaborated on the different manifestations of COVID-19, explaining the cytokine storm and the myocardial picture, as well as the thrombogenicity of the virus. 16 As time allows bigger registries to be set up, we realised that impaired ventricular function as well as significant tricuspid regurgitation in patients with COVID-19 was associated with poor prognosis. 17 Lala et al.…”

Section: Covid-19mentioning

confidence: 99%

“…In one of the first manuscripts on COVID-19 and cardiovascular effects, specifically myocardial injury, Rali et al elegantly elaborated on the different manifestations of COVID-19, explaining the cytokine storm and the myocardial picture, as well as the thrombogenicity of the virus. [ 16 ]…”

Section: Heart Failure Manifestation In Covid-19mentioning

confidence: 99%

Coronavirus Disease 2019 and Heart Failure: A Multiparametric Approach

et al. 2020

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Coronavirus disease 2019 (COVID-19) is a debilitating viral infection and, to date, 628,903 people have died from it, numbers that cannot yet be compared to the 50 million who died in the 1918 flu pandemic. As COVID-19 became better understood, cardiovascular manifestations associated with it were identified. This led to a complete healthcare restructuring with virtual clinics and changes to the triaging of critically ill patients. There are a lot of questions over how COVID-19 affects patients with heart failure (HF) as this condition is a leading cause of cardiovascular death. This review describes the cardiovascular implications of COVID-19 and new practices surrounding the use of telehealth to follow up and triage patients with HF. Current practices supported by medical societies, the role of angiotensin-converting enzyme inhibitors and, finally, a brief note regarding the management of advanced HF patients will also be discussed.

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“…Myocardial abnormalities can be present, even after COVID-19 infection recovery, as previously shown (26, 27, and 28). Mechanisms involved in the onset of myocardial injury in the context of COVID-19 infection, are multiple and include hypoxemia, cytokines storm, microvascular thrombi, coronary plaque instability, systemic and vessels inflammation, myocarditis, sepsis related cardiomyopathy, stress-related cardiomyopathy and arrhythmia (29,30,31,32).…”

Section: Heart and Obesitymentioning

confidence: 99%

Obesity and COVID-19 Infection Severity: From Pathophysiology to Clinical Implications

Fayssoil¹,

Carnavalet²,

Mansencal³

et al. 2020

Preprint

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Obesity is a significant public health concern with higher morbidity. Obesity patients are at risk of severe COVID-19 infection and obesity is a higher risk factor for intensive Care Unit admission in COVID-19 infection. Obesity status affects lung volumes, cardiac structure and hemodynamics. Obesity is associated with a low inflammation state, endothelial dysfunction, hyperinsulinaemia and metabolic disorders. The authors review cardio-respiratory pathophysiological aspects involved in obesity and propose clinical management in obese patients infected by COVD-19.

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Mechanisms of Myocardial Injury in Coronavirus Disease 2019

Cited by 28 publications

References 59 publications

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Coronavirus Disease 2019 and Heart Failure: A Multiparametric Approach

Obesity and COVID-19 Infection Severity: From Pathophysiology to Clinical Implications

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