Heart damage ‘found in majority of Covid patients with raised protein levels’

More than half of patients admitted to hospital with severe Covid-19 and raised levels of a protein called troponin had some form of heart damage after being discharged, UK scientists have found.

Troponin is released into the blood when the heart muscle is injured, and it is thought that up to 40% of Covid-19 patients have raised levels of this protein.

The researchers said the findings, published in the European Heart Journal, raise hope that this injury can be prevented through careful monitoring and targeted treatments.

Professor Marianna Fontana, professor of cardiology at University College London, who led the research, said: “Raised troponin levels are associated with worse outcomes in Covid-19 patients.

“Patients with severe Covid-19 disease often have pre-existing heart-related health problems including diabetes, raised blood pressure and obesity.

“During severe Covid-19 infection, however, the heart may also be directly affected.

“Unpicking how the heart can become damaged is difficult, 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.”

The study, which involved 148 patients from six acute hospitals in London, is believed to be the largest to date investigating recovering Covid-19 patients who had raised troponin levels.

Patients who had abnormal troponin levels were offered a heart scan after discharge and were compared with those from a control group of patients who had not had Covid-19, as well as from 40 healthy volunteers.

The team found evidence of heart damage in the patients with high troponin levels – with scarring or injury to the heart muscle present in 54% of the patients.

The researchers said these injuries did not stop the heart pumping normally but there were concerns the damage may increase the risks of heart failure in the future.

Prof Fontana said: “The recovering Covid-19 patients had been very ill; all required hospitalisation and all had troponin elevation, with around one in three having been on a ventilator in the intensive care unit.

“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.

“Importantly, the pattern of damage to the heart was variable, suggesting that the heart is at risk of different types of injury.”

The team acknowledge that the findings are limited as participants included only those who survived a coronavirus infection that required hospital admission.

Prof Fontana said: “The convalescent patients in this study had severe Covid-19 disease and our results say nothing about what happens to people who are not hospitalised with Covid, or those who are hospitalised but without elevated troponin.”

Commenting on the research, Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, said: “These findings aren’t applicable to people who’ve had mild or asymptomatic Covid-19 infections.”

She added: “Some people in the study may have had heart damage they did not know about before they caught the virus.

“People who had heart damage thought to be caused by the virus often had subtle injuries which did not stop the heart pumping normally.

“More research looking at the long-term effects of severe illness is needed so that we can learn how to prevent and treat any damage that Covid-19 does to the heart.”