Myocardial Injury in End-Stage Heart Failure Patients with COVID-19
Title: End-Stage Heart Failure With COVID-19: Strong Evidence of Myocardial Injury by 2019-nCoV
Authors: Nianguo Dong MD, Jie Cai MD, Ying Zhou MD, Junwei Liu MD, Fei Li MD
In this study, researchers examined the clinical profiles of four end-stage heart failure patients who were infected with COVID-19. The patients displayed varying degrees of illness severity, with two experiencing a severe presentation of the disease. The findings revealed that these patients, similar to previous reports, were predominantly male and exhibited typical symptoms such as lymphopenia and elevated levels of C-reactive protein.
Of particular importance, the study identified a novel finding—both critically ill patients showed a significant 20-fold increase in troponin I levels, indicating myocardial injury. This provides strong evidence linking COVID-19 to cardiac damage. While previous studies mainly focused on nonspecific indicators like creatine kinase-MB and lactate dehydrogenase, this research highlights the direct association between COVID-19 and myocardial injury.
The exact mechanisms underlying the myocardial injury caused by the 2019-nCoV virus remain unclear. However, the study emphasizes the significant impact of COVID-19 on the heart and its correlation with disease progression. It is suggested that older age, comorbidities, poor general condition, and severe myocardial injury are risk factors contributing to the high mortality rate observed in end-stage heart failure patients after contracting pneumonia.
Although the study’s sample size was limited, its findings underscore the need for further research in larger cohorts of heart failure patients to gain a deeper understanding of COVID-19’s prognosis and its effects on the heart. Ultimately, elucidating the mechanisms of myocardial injury in COVID-19 patients will aid in developing effective strategies for managing and treating this complex disease.