The uncertainty regarding COVID-19 is due, in large part, to its newness and the associated lack of verified information regarding how the illness affects the body and how to treat it. As such, a profound emphasis has been placed upon developing a deeper understanding of these factors, which may contribute to better treatments in the future.

Myocardial injury is a common problem among hospitalized COVID-19 patients. Worse, those who suffer from this particular issue often receive a poor prognosis. Despite the knowledge of this correlation, the underlying mechanisms are anything but clear. Adding to the knowledge gap is the fact that cardiovascular imaging data has been omitted from previous studies.

To rectify this particular lack of information, researchers determined to characterize the echocardiographic abnormalities that correlated with COVID-19 patients’ myocardial injuries, as well as the impact they had on prognosis.

The Study

To create an appropriate sample size, this study was conducted in an international, multicenter manner that involved seven total hospitals located in New York City and Milan. Only patients with confirmed COVID-19 were considered, and among those, only those who had a transthoracic echocardiographic and electrocardiographic evaluation conducted were included.

To maintain consistency, myocardial injury was clearly defined and included any elevation in cardiac troponin. This elevation had to occur either at the time of clinical presentation or while the patient was hospitalized.

In total, these parameters limited the participant pool to 305 patients. The mean age of the patients was 63, and of the 305 patients included, 205 were male.

Findings

190 of the 305 patients (62.3%) experienced myocardial injury. Electrocardiographic abnormalities, inflammatory biomarkers, and major echocardiographic abnormalities were all more prevalent in those with myocardial injuries than those without.

The primary outcome measured was in-hospital mortality. This was measured in relation to three groups of patients—those free of myocardial injury, those with myocardial injury but without transthoracic echocardiographic abnormalities, and those with both myocardial injury and transthoracic echocardiographic abnormalities. In-hospital mortality occurred at rates of 5.2%, 18.6%, and 31.7%, respectively.

What it Means

Nearly two-thirds of COVID-19 patients with myocardial injury who underwent transthoracic echocardiographic evaluation displayed abnormalities in cardiac structure. When these abnormalities were present in conjunction with myocardial injury, in-hospital mortality was more likely. However, once variables were accounted for, patients who had both myocardial injury and transthoracic echocardiographic abnormalities were the only group with a higher risk of death.

This blog has been published in collaboration with Prairie Cardiology, the premier Cardiology group in Illinois. Prairie Cardiovascular is a national leader in providing high-quality, state-of-the-art heart and vascular care. Make an appointment with one of the providers today, through ACCESS Prairie program.