Kovid-19 and Dil: two new studies provide insights


The disease caused by the novel coronavirus can damage other organs in the body – including the heart – and now two separate studies, published Monday in the journal JAMA Cardiology, provide more information on how Kovid-19 Can have long-term effects. Heart health is among those who have recovered from the disease and those who have died may have a cardiac infection.

“We have understood for a few months now that Kovid-19 is not just a respiratory infection, but a multi-system infection,” cardiologist Drs. Said Nika Goldberg, Medical Director of NYU Women’s Heart Program and Senior Advisor for Women’s Health Strategy. NYU Langone Health in New York, which was not involved in any study.

“There is an acute inflammatory reaction, increased blood clotting and cardiac involvement. And the heart muscle can either be caused by direct involvement of the heart muscle by infection and its inflammatory response. It may be due to blood clots Which could have formed, causing Goldberg to say that there is a blockage in the arteries.

“Sometimes people have very high heart rates, which over time can weaken the heart muscle, reducing the function of the heart muscle. So during this infection there are many ways that it can involve the heart Can do.”

Heart inflammation

One of the JAMA cardiology studies found that 78% of the 100 adults recently recovered from Kovid showed some type of cardiac involvement in an MRI scan and 60% had heart inflammation.

The study included patients aged 45 to 53 who were from the University Hospital Frankfurt Kövid-19 registry in Germany. He was admitted for the study between April and June. Most patients – 67 – were recovered at home, ranging in severity from their illness, with some ranging from symptomatic to moderate.

Researchers used magnetic resonance imaging of the heart, blood tests and biopsies of heart tissue. Those data were compared with a group of 50 healthy volunteers and 57 volunteers with few underlying health conditions or risk factors.

MRI data showed that people infected with coronovirus were involved in any type of heartbeat, regardless of the severity or course of their infection, their original diagnosis or the presence of symptoms related to a particular heart.

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The most common heart-related abnormality in Kovid-19 patients was myocardial inflammation or abnormal inflammation of the heart muscle, which may weaken it.

Goldberg said that this type of inflammation, also known as myocarditis, is usually caused by a viral infection.

“What they are saying in this study is that you can identify myocardial involvement or cardiac involvement by magnetic resonance imaging,” Goldon said.

There are some limitations of the study. More research is needed to determine whether similar findings will emerge among a larger group of patients, those younger than 18 years of age, and currently struggling with coronovirus infection rather than recovering from it.

The researchers wrote, “These findings point to the need for continued investigation into the long-term cardiac outcomes of COVID-19.”

‘This transition does not follow a path’

In another JAMA cardiology study, autopsy analysis found that coronoviruses could be identified in the heart tissue of Kovid-19 patients who died.
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The study included 39 autopsy data from Germany between 8 April and 18 April. The patients, aged 78 to 89, had tested positive for Kovid-19 and the researchers analyzed heart tissue from their autopsy.

Researchers found that 16 patients had the virus in their heart tissue, but did not show signs of abnormally sudden inflammation in the heart or myocarditis. It is unclear what this means, the researchers said.

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The autopsy sample was small and “the elderly age of the patients may have influenced the results,” the researchers wrote. More research is needed on whether similar findings will emerge among a small group of patients.

“I think both of these studies are important,” Goldberg said.

“One pretty much suggests that MRI scans can help diagnose myocardial injury caused by cecoid and this was confirmed on biopsy,” she said. “The autopsy showed us something else that is interesting – that you may have a viral appearance but not an acute inflammatory process. So this infection does not follow a path.”

‘An increasingly complex puzzle’

Both studies “add to an increasingly complex puzzle” when it comes to the novel coronovirus called SARS-CoV-2, Dr. Dave Montgomery, a cardiologist at PREvent Clinic in Sandy Springs, Georgia, said in an email Tuesday .

“The study concurs that SARS-CoV-2 does not cause clinical myocarditis, so that a large number of viruses can be detected and there is an inflammatory response in the myocardial tissue. In other words, one may have heart involvement. There may be no or mild symptoms. Montgomery said that is actually the cause of the damage, which was not included in the study.

“In general, viruses make their way to organs that are far from the original site of infection. SARS-CoV-2 is no different in this regard,” he said. “What is different is that this virus preferentially affects the heart cells and surrounding cells. These studies suggest that the heart cannot be infected with obvious symptoms. Personally, in my practice, We have seen symptoms similar to inflammation, including pericardial hallucinations. ” , ”Or fluid around the heart pouch.

Dr. of Northwestern University Feinberg School of Medicine Clyde Yancy and Dr. of the University of California, Los Angeles. Greg Fonaro on Monday co-authored an editorial with two new studies in the journal JAMA Cardiology.

Yancey and Fenoro wrote in the editorial, “We see the story thickening and we express a new and very clear concern that COVID-19-related cardiomyopathy and heart failure can potentially develop. “

“We do not want to generate additional concern, but rather incite other investigators to gather new data in other populations to investigate existing and potentially and support or refute these findings,” he wrote.

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