A study on heart scans of COVID-19 patients has revealed more than half had some form of damage.
The study involved 1,216 patients, of whom 813 had been diagnosed with COVID-19, and 298 were deemed probable cases. Due to the design of the study, the remaining 105 were assumed to have COVID-19, the co-authors told Newsweek. The participants were from 69 countries across six continents. They each had an echocardiogram, a type of ultrasound scan for the heart, between April 3 and 20.
Of the total 1,216 patients, 667 (55 percent) had abnormalities in their scan and one in seven participants had what researchers described as "severe abnormalities," according to the paper published in the journal European Heart Journal - Cardiovascular Imaging.
On average, the participants were aged 62, and 70 percent were male. Sixty percent of the scans were performed in a critical care setting, such as an ICU unit or emergency room, while the others were carried out in general medicine settings, cardiology, respiratory, or COVID-19 wards. Some 54 percent of the patients had severe COVID-19.
Those with abnormal scans were more likely to be older and have certain underlying heart problems. But after the team excluded patients with existing heart conditions from their analysis, the proportion of abnormal scan results and those with severe cardiac disease was similar. This suggests that the issues were related to COVID-19, they said.
After patients had their echocardiography scan, one in three saw their course of treatment change.
The study was limited because the team only looked at the results of existing scans. Also, the participants all had heart scans, and the team therefore couldn't measure such problems in those who didn't.
The team noted that COVID-19 largely affects the respiratory tract, and existing research suggests patients with cardiovascular disease or who are at risk of developing it seem to be more susceptible to the disease and have a worse prognosis.
Co-author Professor Marc Dweck, consultant cardiologist at the University of Edinburgh, U.K., said in a statement: "COVID-19 is a complex, multisystem disease which can have profound effects on many parts of the body, including the heart.
"Many doctors have been hesitant to order echocardiograms for patients with COVID-19 because it's an added procedure which involves close contact with patients. Our work shows that these scans are important—they improved the treatment for a third of patients who received them."
He continued: "Damage to the heart is known to occur in severe flu, but we were surprised to see so many patients with damage to their heart with COVID-19 and so many patients with severe dysfunction.
"We now need to understand the exact mechanism of this damage, whether it is reversible and what the long-term consequences of COVID-19 infection are on the heart."
Dweck told Newsweek: "Such heart damage is potentially a very serious problem for these patients, and likely to have an important influence on their ability to survive and recover from the illness.
"However, it is also an excellent opportunity, because we actually have many very good treatments for heart failure. If we can identify the COVID-19 patients with heart involvement, we can introduce therapies to help them get better quicker."
Sonya Babu-Narayan, Associate Medical Director and Consultant Cardiologist at the British Heart Foundation, which funded the study, said in a statement:
"This global study—carried out at the height of the pandemic—shows that we must be on the lookout for heart complications in people with COVID-19 so that we can adapt their treatment, if needed."
This article has been updated to provide clarity on the number of study participants, and comment from Professor Marc Dweck.