More than 50% of patients who were hospitalized with severe Covid-19 were found to have heart damage even months after their discharge, according to a new study.

The study, published in the European Heart Journal, looked at 148 patients from six hospitals around London, U.K. and found that patients who had severe Covid-19 as well as raised levels of a protein called troponin were more likely to have damage to their hearts.

Troponin is released into the blood when the heart muscle is injured and a rise in the levels can happen if something like an artery is blocked or there’s inflammation to the heart. Extremely high levels often indicate the person has suffered a heart attack.

Previous research has shown that about a fifth of patients who are hospitalized with Covid-19 also have elevated troponin levels. Elevated troponin levels have also been linked to poorer outcomes and an increased risk of death.

However, the cause and extent of the damage hasn’t been fully studied.

Using magnetic resonance imaging (MRI), this latest study found several types of damage to the heart in the Covid-19 patients with raised troponin levels including, inflammation of the heart muscle, scarring or death of heart tissue, restricted blood supply to the heart or a combination of all three.

“We found evidence of high rates of heart muscle injury that could be seen on the scans a month or two after discharge. Whilst some of this may have been pre-existing, MRI scanning shows that some were new, and likely caused by Covid-19,” said lead author Professor Marianna Fontana, a professor of cardiology at University College London.

“Importantly, the pattern of damage to the heart was variable, suggesting that the heart is at risk of different types of injury. While we detected only a small amount of ongoing injury, we saw injury to the heart that was present even when the heart’s pumping function was not impaired and might not have been picked up by other techniques.”

To break it down a bit more, the study found that the parts of the heart that are responsible for pumping oxygenated blood to the body was normal in 89% of patients but 54% had signs of scarring or injury to the heart muscle.

Further, just over a quarter had scarring from inflammation, while 22% had either infarction or ischaemia – 6% had both. Finally, the study found that 8% of participants had ongoing heart inflammation.

Fontana explains that while in most cases the cardiac damage is common and won’t likely effect the heart’s function, being able to identify the type of damage can be helpful, especially when it comes to picking out patients who are at higher or lower risk.

“In the most severe cases, there are concerns that this injury may increase the risks of heart failure in the future,” she explained.

“But MRI scans of the heart can identify different patterns of injury, which may enable us to make more accurate diagnoses and to target treatments more effectively,” she said, adding that potential strategies like specific supporting drug treatments to protect heart function over time might be of benefit.

But more research is needed, especially to see how the heart is effected for those who weren’t hospitalized as more and more research is suggesting that a majority of people who got Covid-19 may have lingering heart damage.

For example, a study published in June 2020 in the journal JAMA found that 78% of recently recovered Covid-19 patients had abnormalities of the heart and 60% had ongoing inflammation.

Another study found that 30% of people were experiencing abnormal heart function even 27 months after contracting the virus.

And this is likely just the tip of the iceberg for what may be years of heart problems caused by the virus.

As Elike Nagel told Scientific American: “[Covid-19] will increase the incidence of heart failure over the next decades.”

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