BREAKING! COVID-19 News: Study Shows 39 Percent Of COVID-19 Recovered Healthcare Workers Developed Pericarditis Or/And Myocarditis 10 Weeks Later When Examined
: In a new detailed study conducted by researchers from the University Hospital of Salamanca in Spain that was funded by the Spanish Ministry For Science, in was found that more than 40 percent of 139 health care workers who had recovered from COVID-19 were found to have Pericarditis Or/And Myocarditis when they were examined about 10 weeks later. More than 42 % experienced symptoms associated with cardiac issues such as chest pain, dyspnoea or palpitations, shortness of breath or dizziness. Cardiac Magnetic Resonance(CMR) imaging abnormalities was seen in 75% of them!
The implications of the study are that recovered and asymptomatic individuals are at a very high risk of Pericarditis Or/And Myocarditis, cardiac inflammation and injury and also other heart issues and that all recovered and asymptomatic individuals should be constantly monitored for potential heart issues as its one of the long term health issues associated with COVID-19.
The study findings were published on a preprint server and are currently being peer-reviewed. https://www.medrxiv.org/content/10.1101/2020.07.12.20151316v1
The researchers said that cardiac sequelae of past SARS-CoV-2 infection are still poorly documented.
The research team conducted a cross-sectional study in health-care workers to reported evidence of pericarditis and myocarditis after SARS-CoV-2 infection.
They studied 139 health-care workers with confirmed past SARS-CoV-2 infection (103 diagnosed by RT-PCR and 36 by serology).
Research participants underwent clinical assessment, electrocardiography, laboratory tests including immune cell profiling and cardiac magnetic resonance (CMR) imaging.
Pericarditis was diagnosed when classical criteria were present, and the diagnosis of myocarditis was based on the updated CMR Lake-Louise-Criteria.
The results of the study in brief were as follows: Participants median age was 52 years (IQR 41-57), 100 (72%) were women, and 23 (16%) were previously hospitalized for Covid-19 pneumonia. At examination (10.4 [9.3-11.0] weeks after infection-like symptoms), all participants presented hemodynamic stability. Chest pain, dyspnoea or palpitations were observed in 58 (42%) participants; electrocardiographic abnormalities in 69 (50%); NT-pro-BNP was elevated in 11 (8%); troponin in 1 (1%); and CMR abnormalities in 104 (75%).
The study found that isolated pericarditis was diagnosed in 4 (3%) participants, myopericarditis in 15 (11%) and isolated myocarditis in 36 (26%).
Research participants diagnosed by RT-PCR were more likely to still present symptoms than participants diagnosed by serology (73 [71%] vs 18 [50%]; p=0.027); nonetheless, the prevalence of pericarditis or myocarditis was high in both groups (44 [43%] vs 11 [31%]; p=0.238).
Most research participants (101 [73%]) showed altered immune cell counts in blood, particularly decreased eosinophil (37 [27%]; p<0.001) and increased CD4-CD8-/loT alpha beta-cell numbers (24 [17%]; p<0.001). Pericarditis was associated with elevated CD4-CD8-/loT alpha beta-cell numbers (p=0.011), while participants diagnosed with myopericarditis or myocarditis had l
ower (p<0.05) plasmacytoid dendritic cell, NK-cell and plasma cell counts and lower anti-SARS-CoV-2-IgG antibody levels (p=0.027).
Interestingly another recent retrospective observation in 26 recovered patients with COVID-19 pneumonia presenting cardiac complaints during hospitalization, revealed the presence of myocardial oedema in 14 (54%) patients and late gadolinium enhancement in 8 (31%) patients26. Our results are in agreement with these findings as 89 (64%) of our participants presented myocardial injury in T2 or in T1-based CMR. High rates of myocardial damage are also observed in influenza where elevated cardiac enzymes, electrocardiographic, echocardiographic and histologic findings have been reported in approximately one third of cases. These findings were published in the Journal of the American College of Cardiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214335/
The Spanish researchers concluded that pericarditis and myocarditis with clinical stability are frequent long after SARS-CoV-2 infection, even in presently asymptomatic subjects.
These newly found observations will probably apply to the general population infected and may indicate that cardiac sequelae might occur late in association with an altered (delayed) innate and adaptative immune response.
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