Myocardial injury is a common feature of patients with COVID-19 disease caused by SARS-Cov-2, a finding reported that at least 20% of patients hospitalized for COVID-19 have increased morbidity and mortality. In addition to myocardial injury, troponin is detected in COVID-19 patients and is correlated with abnormal cardiac MRI in convalescent patients.
A unique positive troponin velocity and myocardial injury are reported among individual patients with detectable SARS-CoV-2 viremia, in contrast to patients without detectable viremia. The patients who were examined had characteristics such as: being an elderly person, male, and with a tendency to have more basic cardiovascular comorbidities than patients who did not have positive SARS-CoV-2. These findings suggest that the most vulnerable patients hospitalized for COVID-19 are more likely to have SARS-CoV-2 viremia and to have a degree of consequent myocardial injury.
The study carried out was in a sample of 70 hospitalized people, in which troponin levels and the prevalence of a myocardial injury were compared, where 100% of patients with SARS-CoV-2 viremia have a high level of troponin, and 76% are prone to myocardial injury, according to abnormal cardiac magnetic resonance imaging.
It should be noted that the context and limitations of the study must be taken into account, in which the greatest limitation is the small group and the control of the variables. As a result, the exact relationship between age, sex, history of cardiovascular disease, and SARS-CoV-2 viremia, and myocardial injury cannot be fully judged.
Despite the limitations, the high prevalence of cardiovascular injuries during the SARS-CoV-2 viremia pandemic has been demonstrated. These cardiovascular diseases are associated with the worst outcome prognosis, even taking into account death, making it a key priority to understand the mechanism of this relationship. Viremia plasma is associated with systemic and immunologic disasters and disturbances and may be a mediator of this relationship. Despite the large scale of studies, there is a need to investigate the complexity between SARS-CoV-2 viremia, immune response, risk of cardiac injury, and clinical outcomes. The perspectives of these relationships may open new avenues of diagnosis, different prognoses, and therapy in patients with SARS-CoV-2.
Dr. Roberto Valdes Charles
Est Med Aileen Lopez
REFERENCE
Increased prevalence of myocardial injury in patients with SARS-CoV-2 viremia.
Hasan K. Siddiqi MD, Brittany Weber MD PhD,
The American Journal of Medicine 09/2020
