@article{Shiwani_H-2024_188455,
title = {Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study},
author = {Shiwani, H. and Artico, J. and Moon, J. and Gorecka, M. and McCann, G. and Roditi, G. and Morrow, A. and Mangion, K. and Lukaschuk, E. and Shanmuganathan, M. and Miller, C. and Chiribiri, A. and Alzahir, M. and Ramirez, S. and Lin, A. and Swoboda, P. and McDiarmid, A. and Sykes, R. and Singh, T. and Bucciarelli-Ducci, C. and Dawson, D. and Fontana, M. and Manisty, C. and Treibel, T. and Levelt, E. and Arnold, R. and Young, R. and McConnachie, A. and Neubauer, S. and Piechnik, S. and Davies, R. and Ferreira, V. and Dweck, M. and Berry, C. and Investigators, O. and Greenwood, J.},
month = {aug},
year = {2024},
abstract = {BackgroundHospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.ObjectivesThis study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.MethodsThis was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.ResultsOf 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%;P &lt;0.001), stable right ventricular ejection fraction (0.4% ± 0.8%;P =0.50), no change in myocardial scar pattern or volume (P =0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P &lt;0.001).ConclusionsMyocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart;ISRCTN58667920)},
pages = {1320-1331},
volume = {17},
issue = {11},
journal = {JACC: Cardiovascular Imaging},
publisher = {JACC Journals},
url = {https://doi.org/10.1016/j.jcmg.2024.06.008},
}
